Quist Mark, Yim Joon, Mirkin Gene, Hao Xingpei
*Foot and Ankle Specialists of the Mid-Atlantic, LLC, Huntersville, NC.
†Foot and Ankle Specialists of the Mid-Atlantic, LLC, Rockville, MD.
J Am Podiatr Med Assoc. 2023 Jul-Aug;113(4). doi: 10.7547/21-108.
Nevoid melanoma (NeM) is a rare variant of malignant melanoma characterized by slight cellular atypia, polymorphism, and incomplete maturation. It most frequently occurs on the trunk and arms but rarely on the foot. Here, we report a subungual NeM of the right hallux. A 65-year-old man presented with severe pain of 6 months' duration to his right great toe following self-treatment for an ingrown nail. He was evaluated and treated with debridement of the toenail at an urgent medical center 3 months prior. However, this had not relieved his pain. The patient also noticed discoloration of his distal great toe over the past 3 months. Removal of part of the ingrown nail revealed a pigmented mass extending distally from the matrix. Surgical excision of the mass was performed because of the concern for malignancy. The diagnosis of NeM was based on histologic analysis along with enhanced diagnostic modalities. The patient was further treated with surgical amputation of the great toe and anti-programmed cell death-1 therapy. The patient had no relapse at 1-year follow-up. Nevoid melanoma is a rare variant of malignant melanoma on the toes, which needs to be differentiated from a nevus with atypia, with a variety of modalities including cellular and molecular profiling. The optimal treatment is amputation.
无色素性黑色素瘤（NeM）是恶性黑色素瘤的一种罕见变体，其特征为细胞异型性轻微、多形性和不完全成熟。它最常发生于躯干和手臂，而很少发生于足部。在此，我们报告一例右拇趾甲下无色素性黑色素瘤。一名65岁男性，因自行处理嵌甲后，右拇趾出现持续6个月的剧痛。3个月前，他在一家紧急医疗中心接受了趾甲清创评估和治疗。然而，这并未缓解他的疼痛。在过去3个月里，患者还注意到其拇趾远端变色。切除部分嵌甲后发现一个色素性肿物从甲床向远端延伸。由于担心恶变，对该肿物进行了手术切除。无色素性黑色素瘤的诊断基于组织学分析以及增强诊断方法。患者进一步接受了拇趾手术截肢及抗程序性细胞死亡蛋白1治疗。在1年的随访中，患者未复发。无色素性黑色素瘤是脚趾上恶性黑色素瘤的一种罕见变体，需要通过包括细胞和分子分析在内的多种方式与非典型痣相鉴别。最佳治疗方法是截肢。
