Differential diagnosis of subungual melanoma from a surgical point of view

Subungual lesion referred to a surgical unit over a 17-year period have been reviewed to assess problems of differential diagnosis and management of suspected subungual melanoma. Such lesions are uncommon, even in a unit with interest in melanoma. Only four melanomas were seen for primary treatment, and eight in all, during the period. We describe the clinical features of other subungual lesions seen in surgical patients which might help in their differentiation from melanoma. Differential diagnosis and a management policy to achieve early diagnosis are discussed in the light of data from this series and study of the relevant literature.