Kiryu H
Department of Dermatology, Kitakyushu Municipal Medical Center, Japan.
J Dermatol. 1998 Jan;25(1):41-4. doi: 10.1111/j.1346-8138.1998.tb02344.x.
A very rare case of malignant melanoma in situ of the nail unit of a child is presented. Clinically, a pigmented streak was present on the finger nail of a 3-year-old girl, and the lesion increased in size and in darkness of the color associated with periungual pigmentation in the following two years. Histopathologically, sections showed proliferation of atypical melanocytes, arranged mostly in single units but some in nests, in and above the basal layer of the epithelium and admixed with long dendrites and a few mitotic figures. Pigmented lesions of nail units of children often show fading or loss of pigmentation clinically; however, a biopsy should be done when they show augmentative changes which clinically suggest malignancy, because subungual malignant melanoma can exist even in children, and proper biopsy can detect it in its early stages.
本文报告了一例极为罕见的儿童甲单位原位恶性黑色素瘤病例。临床上，一名3岁女童的指甲上出现了一条色素沉着条纹，在接下来的两年里，病变大小增加，颜色加深，并伴有甲周色素沉着。组织病理学检查显示，切片可见非典型黑素细胞增生，主要呈单个排列，但也有一些呈巢状，位于上皮基底层内及上方，混有长树突和少量有丝分裂象。儿童甲单位的色素性病变在临床上常表现为色素减退或消失；然而，当它们出现临床上提示恶性的增大变化时，应进行活检，因为儿童也可能存在甲下恶性黑色素瘤，适当的活检可以在早期检测到它。
