Department of Dermatology, University of Florence, Piazza Indipendenza 11, Firenze 50100, Italy.
Expert Rev Anticancer Ther. 2011 May;11(5):749-61. doi: 10.1586/era.10.216.
Subungual melanoma (SUM) is infrequent in the general population, accounting for 0.7-3.5% of all cutaneous melanomas. SUM absolute incidence is similar among different racial groups; however, the relative proportion among overall cutaneous melanoma cases within each population varies in relation to the frequency of sun-induced melanoma. Subungual melanoma most commonly presents as a discoloration of the nail, followed by a recalcitrant wound, a tumor, nail splitting and nail bed bleeding. In most cases, the clinical presentation will already exhibit features typical of late-stage lesions because many patients wait for several months or even years before consulting a physician for evaluation of nail changes. Misdiagnosis of SUM as subungual hematoma, chronic trauma or onychomycosis is still a frequent occurrence, significantly reducing the chances for early treatment. An appropriate diagnostic approach is crucial to allow early-stage diagnosis. The correct management of SUM hinges on early diagnosis and selection of the most appropriate surgical technique. Curative treatment of SUM currently entails surgical excision when the extent of invasion is limited.
甲下黑色素瘤（SUM）在普通人群中较为罕见，占所有皮肤黑色素瘤的 0.7-3.5%。SUM 的绝对发病率在不同种族群体中相似；然而，在每个人群中，作为所有皮肤黑色素瘤病例的相对比例，与阳光诱发的黑色素瘤的频率有关。甲下黑色素瘤最常见的表现为指甲变色，其次是难治性伤口、肿瘤、指甲分裂和甲床出血。在大多数情况下，临床表现已经表现出晚期病变的特征，因为许多患者在咨询医生评估指甲变化之前，会等待数月甚至数年。SUM 被误诊为甲下血肿、慢性创伤或甲真菌病仍然很常见，这大大降低了早期治疗的机会。适当的诊断方法对于早期诊断至关重要。SUM 的正确治疗方法取决于早期诊断和选择最合适的手术技术。目前，当侵袭范围有限时，SUM 的治愈性治疗需要手术切除。
