1
|
Silva García GA, Sánchez Cárdenas CD, Mendoza Ibarra T, Pérez Martínez CA, Guevara Castillo RM, Pulido Díaz N. Clinical and Histopathologic Features of Subungual Melanoma in 57 Mexican Patients: A 5-Year Cohort Study. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:293-297. [PMID: 37871891 DOI: 10.1016/j.ad.2023.05.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/04/2023] [Accepted: 05/12/2023] [Indexed: 10/25/2023] Open
Abstract
Although subungual melanoma is uncommon, it is associated with worse outcomes than melanomas in other locations and accounts for 1% to 23% of all melanomas, depending on the population. The aim of this study was to describe the clinical and histopathologic features of subungual melanoma in a Mexican population. We identified 303 patients with melanoma, and of these, 19% (57 patients with a median age of 71 years) had subungual melanoma. The main sites affected were the lower limbs (52.6%) and the toe (75.4%). The most common histologic subtype was acral lentiginous melanoma (50.9%). Median Breslow thickness was 3 mm, and stage IA tumors were the most common (in 28.1% of patients). Recurrence and metastasis occurred in 19.3% and 8.8% of patients, respectively. The clinical and histopathologic features identified are similar to those described in the literature. Early diagnosis and treatment are crucial for improving prognosis.
Collapse
Affiliation(s)
- G A Silva García
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, México
| | - C D Sánchez Cárdenas
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, México.
| | - T Mendoza Ibarra
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, México
| | - C A Pérez Martínez
- Departamento de Medicina Interna, Hospital General «Ajusco Medio», Secretaría de Salud de México, Estado de México, México
| | - R M Guevara Castillo
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, México
| | - N Pulido Díaz
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, México
| |
Collapse
|
2
|
Silva García GA, Sánchez Cárdenas CD, Mendoza Ibarra T, Pérez Martínez CA, Guevara Castillo RM, Pulido Díaz N. [Translated article] Clinical and Histopathologic Features of Subungual Melanoma in 57 Mexican Patients: A 5-Year Cohort Study. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T293-T297. [PMID: 38242433 DOI: 10.1016/j.ad.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/12/2023] [Indexed: 01/21/2024] Open
Abstract
Although subungual melanoma is uncommon, it is associated with worse outcomes than melanomas in other locations and accounts for 1% to 23% of all melanomas, depending on the population. The aim of this study was to describe the clinical and histopathologic features of subungual melanoma in a Mexican population. We identified 303 patients with melanoma, and of these, 19% (57 patients with a median age of 71 years) had subungual melanoma. The main sites affected were the lower limbs (52.6%) and the toe (75.4%). The most common histologic subtype was acral lentiginous melanoma (50.9%). Median Breslow thickness was 3 mm, and stage IA tumors were the most common (in 28.1% of patients). Recurrence and metastasis occurred in 19.3% and 8.8% of patients, respectively. The clinical and histopathologic features identified are similar to those described in the literature. Early diagnosis and treatment are crucial for improving prognosis.
Collapse
Affiliation(s)
- G A Silva García
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, Mexico
| | - C D Sánchez Cárdenas
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, Mexico.
| | - T Mendoza Ibarra
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, Mexico
| | - C A Pérez Martínez
- Departamento de Medicina Interna, Hospital General «Ajusco Medio», Secretaría de Salud de México, Estado de México, Mexico
| | - R M Guevara Castillo
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, Mexico
| | - N Pulido Díaz
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, Mexico
| |
Collapse
|
3
|
Tsiogka A, Rubin AI, Gregoriou S, Soulaidopoulos S, Belyayeva H, Rigopoulos D. Prevalence of subungual melanoma in patients with cutaneous malignant melanoma: A systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2024; 38:77-83. [PMID: 37644688 DOI: 10.1111/jdv.19482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 08/09/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Subungual melanoma (SUM) is a rare type of cutaneous malignant melanoma (CMM) associated with poor prognosis, while data regarding its prevalence are scarce. OBJECTIVES We sought to provide a comprehensive systematic review and meta-analysis of the prevalence rates of SUM among all types of CMM, considering certain demographic and clinical characteristics. METHODS The MEDLINE electronic database was searched systematically to identify eligible studies providing prevalence rate estimates of SUM in patients with CMM. Included studies were further analysed to estimate the relative prevalences of SUM according to study design, study years, geographical region and sex distribution. RESULTS Twenty-eight studies met the inclusion criteria. The overall SUM prevalence was 1.9% (95% CI [1.5%-2.3%]). The prevalence of SUM did not differ significantly between population- and hospital-based studies and remained stable over time. However, it was found to be significantly higher in Asians compared to patients of other geographical regions as well as in studies with more men than women compared to those with female preponderance (p < 0.001). CONCLUSIONS In all, the overall SUM prevalence among all subtypes of CMM was estimated at 1.9%, without significant changes over time, and was found to exhibit significant variability between subgroups of different geographical regions.
Collapse
Affiliation(s)
- Aikaterini Tsiogka
- Faculty of Medicine, First Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Adam I Rubin
- Department of Dermatology, Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Stamatios Gregoriou
- Faculty of Medicine, First Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Stergios Soulaidopoulos
- First Department of Cardiology, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Helena Belyayeva
- Faculty of Medicine, First Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitris Rigopoulos
- Faculty of Medicine, First Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
4
|
Greco P, Pham F, Duru G, Lainé X, Dalle S, Thomas L. Evaluation of the Knowledge of Primary Care Physicians About Important Nail Diseases Before and After a Short Online Training. Dermatol Pract Concept 2023; 13:e2023170. [PMID: 37557138 PMCID: PMC10412044 DOI: 10.5826/dpc.1303a170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Nail diseases are often diagnosed late with a potential prognostic and functional impact. This could be partly due to knowledge gaps among primary care physicians (PCPs). OBJECTIVES To evaluate the knowledge about diagnosis and management of ten common/important nail conditions in a population of French PCPs and its improvement after a 31-minute online training session. METHODS We submitted 10 pre-test and post-test clinical cases and an educative online course on the diagnosis and the management of nail diseases to 138 volunteer PCPs; 73 completed the whole training path. RESULTS Compared to pre-test, more PCPs in the post-test required an urgent second opinion to dermatologist for pigmented melanoma (100% versus 80.3%; P <0.05) and use of inappropriate/dangerous systemic treatment for trauma-induced nail changes was reduced after the training program (0% versus 6.8%; P <0.05). A lack of knowledge remained after training for amelanotic melanoma with an increase of mycological/bacteriological tests (9.6% versus 0%; P <0.05). CONCLUSIONS Management of nail diseases by our panel of PCPs was suboptimal and was improved after a short online training.
Collapse
Affiliation(s)
- Pauline Greco
- Dermatology department, Hôpital Lyon Sud, Hospices Civils de Lyon, Lyons, France
- Claude Bernard Lyon-1 University, Lyon, France
| | - Félix Pham
- Dermatology department, Hôpital Lyon Sud, Hospices Civils de Lyon, Lyons, France
- Claude Bernard Lyon-1 University, Lyon, France
| | - Gérard Duru
- Claude Bernard Lyon-1 University, Lyon, France
| | | | - Stéphane Dalle
- Dermatology department, Hôpital Lyon Sud, Hospices Civils de Lyon, Lyons, France
- Claude Bernard Lyon-1 University, Lyon, France
- Cancer Research Center of Lyon, Lyons, France
| | - Luc Thomas
- Dermatology department, Hôpital Lyon Sud, Hospices Civils de Lyon, Lyons, France
- Claude Bernard Lyon-1 University, Lyon, France
- Cancer Research Center of Lyon, Lyons, France
| |
Collapse
|
5
|
Arango Abisaad J, Arciniegas Grisales V, Londoño García Á, Vasquez Trespalacios E, Jiménez Calfat G, Cuello López J. [Translated article] Characteristics of Acral Lentiginous Melanoma According to Location in Stress- or Non–Stress-Bearing Areas: A Retrospective Study of 95 Patients. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2021.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
6
|
Características del melanoma lentiginoso acral según su relación con la presión. Estudio retrospectivo de 95 pacientes. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:134-140. [DOI: 10.1016/j.ad.2021.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 08/26/2021] [Accepted: 08/31/2021] [Indexed: 11/22/2022] Open
|
7
|
Arango Abisaad J, Arciniegas Grisales V, Londoño García Á, Vasquez Trespalacios E, Jiménez Calfat G, Cuello López J. Characteristics of Acral Lentiginous Melanoma According to Location in Stress- or Non–Stress-Bearing Areas: A Retrospective Study of 95 Patients. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2021.11.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
8
|
Holman BN, Van Gulick RJ, Amato CM, MacBeth ML, Davies KD, Aisner DL, Robinson WA, Couts KL. Clinical and molecular features of subungual melanomas are site-specific and distinct from acral melanomas. Melanoma Res 2020; 30:562-573. [PMID: 33156595 DOI: 10.1097/cmr.0000000000000688] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Subungual melanomas (SUM) arise beneath the nails of the hands and feet, and account for 0.7-3.5% of all malignant melanomas. Most studies include SUM in the category of acral melanoma, but understanding the specific features of SUM is critical for improving patient care. In this study, we performed a site-specific comparison of the clinical and molecular features between 54 cases of SUM and 78 cases of nonsubungual acral melanoma. Compared to patients with acral melanoma, patients with SUM were younger at diagnosis, had a higher prevalence of primary melanomas on the hand, and had more frequent reports of previous trauma at the tumor site. SUM was deeper than acral melanoma at diagnosis, which correlated with an increased frequency of metastases. Analysis of common melanoma driver genes revealed KIT and KRAS mutations were predominantly found in SUM, whereas BRAF and NRAS mutations occurred almost exclusively in acral melanoma. We also discovered molecular differences in the cell cycle pathway, where CDK4/CCND1 amplifications were more frequent in SUM and CDKN2A/B loss occurred mostly in acral melanoma, and in the PI3K/mTOR pathway, where RICTOR amplification and TSC1 K587R mutations were exclusively in SUM and PTEN loss and AKT1 mutations were exclusively in acral melanoma. Comparison of hand versus foot tumors revealed more frequent ulceration of SUM foot tumors, which correlated with more distal metastases and poorer overall survival. In summary, we find SUM are both clinically and molecularly distinct from acral melanoma, and our data suggest KIT, CDK4/6, and mTOR inhibitors may be particularly relevant and effective treatments for patients with SUM.
Collapse
Affiliation(s)
- Blair N Holman
- Division of Medical Oncology, Department of Medicine
- Center for Rare Melanomas
| | - Robert J Van Gulick
- Division of Medical Oncology, Department of Medicine
- Center for Rare Melanomas
| | - Carol M Amato
- Division of Medical Oncology, Department of Medicine
- Center for Rare Melanomas
| | - Morgan L MacBeth
- Division of Medical Oncology, Department of Medicine
- Center for Rare Melanomas
| | - Kurtis D Davies
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Dara L Aisner
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - William A Robinson
- Division of Medical Oncology, Department of Medicine
- Center for Rare Melanomas
| | - Kasey L Couts
- Division of Medical Oncology, Department of Medicine
- Center for Rare Melanomas
| |
Collapse
|
9
|
Murthy NK, Broski SM, Amrami KK, Markovic SN, Spinner RJ. Extensive Perineural Spread of Subungual Melanoma. World Neurosurg 2020; 145:98-101. [PMID: 32916345 DOI: 10.1016/j.wneu.2020.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 09/03/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Subungual melanoma (SUM) is a rare form of melanoma confined to the nailbed and is rarely of the desmoplastic subtype. The often subtle nature of SUM, initially starting as a small dark spot or line in the nailbed, means deeper invasion can occur before a patient seeks clinical evaluation for a large, ulcerated lesion. We report the only known case of perineural spread of SUM of the lower extremity and describe its extensive path of perineural spread from the toe. CASE DESCRIPTION A 72-year-old man with a distant history of SUM status post second ray amputation, presented for evaluation of ipsilateral foot drop. Imaging revealed nodular involvement of tibial, peroneal, and sciatic nerves. Biopsies revealed desmoplastic melanoma and he was treated with nivolumab. CONCLUSIONS We report the only known case of perineural spread of SUM of the lower extremity and describe the pathoanatomy of perineural spread. A high index of suspicion for recurrent disease should be maintained even many years after completion of treatment.
Collapse
Affiliation(s)
- Nikhil K Murthy
- Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | | | - Robert J Spinner
- Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA.
| |
Collapse
|
10
|
Kostaki M, Plaka M, Stergiopoulou A, Kypreou K, Chardalia V, Befon A, Kostopoulos E, Theologi V, Christofidou E, Chasapi V, Polydorou D, Rigopoulos D, Stratigos A. Subungual melanoma: the experience of a Greek melanoma reference centre from 2003 to 2018. J Eur Acad Dermatol Venereol 2020; 34:e231-e234. [PMID: 31944385 DOI: 10.1111/jdv.16193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M Kostaki
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - M Plaka
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - A Stergiopoulou
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - K Kypreou
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - V Chardalia
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - A Befon
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - E Kostopoulos
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - V Theologi
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - E Christofidou
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - V Chasapi
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - D Polydorou
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - D Rigopoulos
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - A Stratigos
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| |
Collapse
|
11
|
Wollina U, Tempel S, Hansel G. Subungual melanoma: A single center series from Dresden. Dermatol Ther 2019; 32:e13032. [DOI: 10.1111/dth.13032] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/01/2019] [Accepted: 07/20/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Uwe Wollina
- Department of Dermatology and AllergologyReconstructive Surgery, and Hand Surgery, Städtisches Klinikum Dresden, Academic Teaching Hospital Dresden Germany
| | - Sven Tempel
- Department of Trauma Surgery, Reconstructive Surgery, and Hand SurgeryStädtisches Klinikum Dresden, Academic Teaching Hospital Dresden Germany
| | - Gesina Hansel
- Department of Dermatology and AllergologyReconstructive Surgery, and Hand Surgery, Städtisches Klinikum Dresden, Academic Teaching Hospital Dresden Germany
| |
Collapse
|