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• W2895562014 abstract "Subungual melanoma constitutes a diagnostic challenge because it often has an atypical clinical presentation. The aims of this study were to revise the clinical and pathologic characteristics of patients with subungual melanoma diagnosed at a tertiary care university hospital and analyze the factors potentially associated with a delayed diagnosis. We analyzed data for 34 patients diagnosed with subungual melanoma at our hospital over a period of 20 years. The study population comprised 18 women and 16 men with a median age at diagnosis of 66 years. Only 5 of the patients had longitudinal melanonychia when examined at the dermatology department. At the time of diagnosis, 19 of the 34 patients had invasive melanoma (median Breslow thickness, 3.70 mm); 16 had ulceration and 8 had regional lymph node involvement. Five patients had subungual melanoma in situ at diagnosis. The median time from appearance of the lesions to consultation at a primary care center was 15 months; the corresponding time from primary care consultation to diagnosis at our hospital was 5.5 months. Lesions located on the toes were more likely to be ulcerated (P = .017) and to be accompanied by regional lymph node involvement at diagnosis (P = .012). The factors associated with a longer diagnostic delay in patients with subungual melanoma were absence of melanonychia as a presenting feature and involvement of the toes. El melanoma subungueal constituye un reto diagnóstico por su presentación clínica frecuentemente atípica. El objetivo del estudio fue revisar las características clínico-patológicas de los pacientes con melanoma subungueal diagnosticados en un hospital universitario de tercer nivel y analizar los factores posiblemente asociados al retraso del diagnóstico. Fueron analizados los datos de 34 pacientes diagnosticados de melanoma subungueal durante 20 años en nuestro centro. Del total de pacientes, 18 eran mujeres y 16 eran varones, con una edad mediana al diagnóstico de 66 años. Únicamente 5 de los pacientes presentaron melanoniquia longitudinal al ser visitados en nuestro Servicio de Dermatología. De los 34 pacientes, 19 presentaron melanoma invasivo al diagnóstico, con una mediana de índice de Breslow de 3,70 mm; 16 presentaron ulceración y 8 invasión ganglionar regional al diagnóstico. Cinco pacientes fueron diagnosticados en fase de melanoma in situ. La mediana del tiempo de evolución de las lesiones desde su aparición hasta la consulta al Centro de Asistencia Primaria fue de 15 meses, y desde la consulta al Centro de Asistencia Primaria hasta el diagnóstico en nuestro hospital fue de 5,5 meses. Las lesiones localizadas en los dedos de los pies presentaron con mayor frecuencia ulceración (p = 0,017) y una mayor probabilidad de invasión ganglionar regional al diagnóstico (p = 0,012). Los factores que en nuestro estudio se asociaron a un mayor retraso del diagnóstico del melanoma subungueal fueron la ausencia de melanoniquia como presentación clínica inicial y la localización de las lesiones en los dedos de los pies." @default.
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• W2895562014 date "2018-11-01" @default.
• W2895562014 modified "2023-09-27" @default.
• W2895562014 title "Subungual Melanoma: A Descriptive Study of 34 Patients" @default.
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• W2895562014 doi "https://doi.org/10.1016/j.adengl.2018.09.002" @default.
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