- 期刊
Subungual Amelanotic Melanoma-A Case Report
趾甲下無黑色素黑色素瘤－病例報告
摘要
整形外科醫生在評估皮膚病灶時，無黑色素之黑色素瘤呈現一種特別的診斷陷阱。缺乏臨床上明顯的色素使得黑色素瘤的基本特徵被忽略。在此我們報告一位七十二歲女性病患在最近一年內發現在右大腳趾甲床有持續性無黑色素潰瘍，而且趾甲也被破壞。病患首先接受清創及植皮手術。很不幸地，病理報告顯示為惡性無黑色素黑色素瘤。後續病患接受右大腳趾截肢手術。在十二個月後的追蹤沒有復發的情況。 因為病灶的常見錯誤診斷以及延遲治療可能使不良的預後更加惡化，所以任何持續性的甲床病灶均應作切片檢查以排除黑色素瘤的可能性。
關鍵字
無資料並列摘要
Amelanotic melanoma presents a unique diagnostic pitfall to plastic surgeon evaluating the skin lesion. The lack of clinically perceptible pigment eliminates the cardinal feature that signals concern for melanoma. We hereby report a 72-year-old female sustained a persistent amelanotic ulcer of the nail bed of the right great toe for 1 year, associated with destruction of the overlying nail plate. The surgical treatments of debridement and skin graft were done at first. Unfortunately, the pathological report revealed this amelanotic ulcer was malignant amelanotic melanoma and the toe was amputated subsequently at the first metatarsophalangeal joint level. There was no sign of recurrence at 12-month follow-up. The poor prognosis of this disease entity is probably aggravated by the common misdiagnosis and delayed treatment of the lesion, therefore, an incisional biopsy should be performed in any persistent nail bed lesion to exclude the possibility of amelanotic melanoma.