Melanoma and squamous cell carcinoma on different nails of the same hand

• Published in: Journal of the American Academy of Dermatology 2008-02, Vol.58 (2), p.323-326
• Main Authors: Harwood, Michael, MD, Telang, Gladys H., MD, Robinson-Bostom, Leslie, MD, Jellinek, Nathaniel, MD
• Format: Article
• Language: English
• Subjects: Aged, 80 and over; Biological and medical sciences; Biopsy; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Dermatology; Humans; Male; Medical sciences; Melanoma, Amelanotic - pathology; Melanoma, Amelanotic - surgery; Mohs Surgery; Nail Diseases - pathology; Nail Diseases - surgery; Neoplasms, Multiple Primary - pathology; Neoplasms, Multiple Primary - surgery; Skin Neoplasms - pathology; Skin Neoplasms - surgery; Tumors of the skin and soft tissue. Premalignant lesions
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2007.08.031

Nail dyschromia, including melanonychia and erythronychia, encompasses a wide range of possible diagnoses. While the majority of these lesions are benign, malignancies of the nail unit represent a sinister, and potentially life-threatening, cause of nail dyschromia. Unfamiliarity with tumors of the nail apparatus can lead to a delay in diagnosis. A case is presented of a patient with two separate and concurrent malignant neoplasms of the nail unit, on different nails on the same hand, each featuring an unusual clinical presentation: amelanotic melanoma presenting as longitudinal erythronychia and squamous cell carcinoma in situ presenting as longitudinal melanonychia. This presentation underscores the need for a low threshold for biopsy in the presence of nail dyschromia of uncertain etiology.