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Subungual Melanoma In Situ in a Hispanic Girl Treated With Functional Resection and Reconstruction With Onychocutaneous Toe Free Flap

Adriana Motta, MD; Carlos López, MD; Alvaro Acosta, MD; Camilo Peñaranda, MD
Arch Dermatol. 2007;143(12):1589-1603. doi:10.1001/archderm.143.12.1600.
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Melanoma of the ungual apparatus represents less than 3% of all cases of cutaneous melanoma.1 To our knowledge, the medical literature reports only 6 cases of subungual melanomas in children,2 and we report the first case of a subungual melanoma in a child treated with slow Mohs surgery and reconstructive surgery with a free flap to restore function.

Mendonça  IKac  BSilva  RSpinelli  LOrofino  RFrança  J Nail apparatus melanoma. An Bras Dermatol 2004;79 (5) 575- 580
Link to Article[[XSLOpenURL/10.1590/S0365-05962004000500008]]
Antonovich  DDGrin  CGrant-Kels  J Childhood subungual melanoma in situ in diffuse nail melanosis beginning as expanding longitudinal melanonychia. Pediatr Dermatol 2005;22 (3) 210- 212
PubMed Link to Article[[XSLOpenURL/10.1111/pde.2005.22.issue-3]]
Acosta  AE Melanoma in Colombia.  Poster presented at the Sixth World Congress on Melanoma September 2005 Vancouver, British Columbia, Canada
Goettmann-Bonvallot  SAndré  JBelaich  S Longitudinal melanonychia in children: a clinical and histopathologic study of 40 cases. J Am Acad Dermatol 1999;41 (1) 17- 22
PubMed Link to Article[[XSLOpenURL/10.1016/S0190-9622(99)70399-3]]
Banfield  CCDawber  RPR Nail melanoma: a review of the literature with recommendations to improve patient management. Br J Dermatol 1999;141 (4) 628- 632
PubMed Link to Article[[XSLOpenURL/10.1046/j.1365-2133.1999.03099.x]]
Moehrle  MMetzger  SSchippert  WGarbe  CRassner  GBreuninger  H “Functional” surgery in subungual melanoma. Dermatol Surg 2003;29 (4) 366- 374
PubMed
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Figures

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Figure 1.

A brown macule with black longitudinal streaks and Hutchinson sign on the right thumb.

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Figure 2.

Atypical melanocytes with huge hyperchromatic nuclei distributed in all epidermal layers (pagetoid dissemination) (hematoxylin-eosin, original magnification ×10.

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Figure 3.

Right thumb following tumor excision.

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Figure 4.

Arterial plexus marked on the right foot for donor nail apparatus.

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Figure 5.

Excision of the nail apparatus from the hallux with corresponding artery, vein, and nerve.

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Figure 6.

Three month follow-up.

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