Ocampo-Garza Jorge, Peña-Romero Adriana G, Bertolli Eduardo, Reyes Soto Mayra A, Gioia Di Chiacchio Nilton, Belfort Francisco A, Fonte-Avalos Veronica, Di Chiacchio Nilton, Domínguez-Cherit Judith
Hospital Universitario "Dr. José Eleuterio González", Monterrey, Mexico.
Hospital Aranda de la Parra, León, Mexico.
Skin Appendage Disord. 2025 Mar 20:1-9. doi: 10.1159/000544995.
Nail unit melanoma (NUM) is a rare but aggressive malignancy with historically poor outcomes. Currently, there are no treatment guidelines for NUM.
A retrospective analysis was conducted on patients diagnosed with NUM in Mexico and Brazil. Clinical and histopathological data were reviewed, and outcomes were compared between those who underwent amputation versus digit preservation surgery. Survival rates, recurrence, and functional status were assessed.
A total of 75 patients from Mexico (51.9%) and Brazil (48.1%) were evaluated. Clinical and pathological characteristics were similar between both groups. Functional surgery was performed in 40 patients (49.4%), including six with invasive melanomas. The median follow-up was 50.3 months (95% CI: 29.4-71.3, SE: 10.7). Among the 7 patients with invasive melanomas who underwent functional surgery, one experienced a recurrence, and one died from a cerebrovascular accident. The remaining 5 patients are alive and disease-free, with follow-up periods ranging from 1 to 27 months.
Non-amputative surgery may be a safe alternative for thin NUMs, reducing amputation-related morbidity. Long-term follow-up and larger studies are needed to confirm guidelines.
甲单位黑色素瘤（NUM）是一种罕见但侵袭性强的恶性肿瘤，以往预后较差。目前，尚无NUM的治疗指南。
对在墨西哥和巴西诊断为NUM的患者进行回顾性分析。回顾临床和组织病理学数据，并比较接受截肢术与保留指手术患者的结局。评估生存率、复发情况和功能状态。
共评估了来自墨西哥（51.9%）和巴西（48.1%）的75例患者。两组的临床和病理特征相似。40例患者（49.4%）接受了功能手术，其中6例为侵袭性黑色素瘤。中位随访时间为50.3个月（95%CI：29.4 - 71.3，标准误：10.7）。在接受功能手术的7例侵袭性黑色素瘤患者中，1例复发，1例死于脑血管意外。其余5例患者存活且无疾病，随访期为1至27个月。
对于厚度较薄的NUM，非截肢手术可能是一种安全的选择，可降低与截肢相关的发病率。需要长期随访和更大规模的研究来确定指南。
