Dermatology Book

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Subungual MelanomaAka: Ungual Melanoma, Hutchinson's sign, Hutchinson's Melanotic Whitlow

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  1. See Also
    1. Melanoma
  2. Epidemiology
    1. Represents 2.5% of Melanomas
  3. Characteristics
    1. Longitudinal brown-black streak
    2. May encompass entire nail
    3. Hutchinson's sign
      1. Melanoma affecting proximal nail fold
  4. Factors suggesting Melanoma
    1. Recent change (e.g. band wider or darker)
    2. Hutchinson's Sign (see above)
    3. Individual nail involvement (especially first digit)
    4. Longitudinal band >3 mm wide
    5. New onset in caucasian or age >60 years
      1. May be normal variant in dark-skinned patients
      2. However, Melanoma also occurs in dark-skin patients
  5. Differential Diagnosis
    1. See Melanonychia
    2. Nail Longitudinal Band

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