Subungual melanoma: A 25‐year review of cases

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Abstract
The purpose of this study was to evaluate subungual melanoma as a site specific entity, to determine the influence of regional nodal involvement, and to ascertain where possible the role of histologic grading of the primary site. Thirty‐three patients with subungual melanoma whose median age was 56 yr underwent treatment between 1950 and 1975. There were 11 male and 22 female patients. Forty‐eight per cent of lesions occurred on the hand. Of 23 clinical stage I patients, seven patients underwent amputation only, while 16 patients underwent amputation and regional nodal dissection. Histologic examination of the primary tumor suggested a trend towards thicker/ulcerated lesions to be associated with metastatic melanoma in regional lymph nodes and/or death due to disease. Early survival patterns favored female patients but there was no significant difference in 10‐year survival when analysed by patient sex. Clinical/pathologic stages were the most significant factors affecting long‐term survival with 5‐ and 10‐year survivals of 66% and 55% in stage I patients and 22% and 0% in stage II patients.