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Subungual Melanoma

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181. Distinct sets of genetic alterations in melanoma. (PubMed)

of exposure to ultraviolet light differs: 30 melanomas from skin with chronic sun-induced damage and 40 melanomas from skin without such damage; 36 melanomas from palms, soles, and subungual (acral) sites; and 20 mucosal melanomas.We found significant differences in the frequencies of regional changes in the number of copies of DNA and mutation frequencies in BRAF among the four groups of melanomas. Samples could be correctly classified into the four groups with 70 percent accuracy on the basis (...) Distinct sets of genetic alterations in melanoma. Exposure to ultraviolet light is a major causative factor in melanoma, although the relationship between risk and exposure is complex. We hypothesized that the clinical heterogeneity is explained by genetically distinct types of melanoma with different susceptibility to ultraviolet light.We compared genome-wide alterations in the number of copies of DNA and mutational status of BRAF and N-RAS in 126 melanomas from four groups in which the degree

2005 NEJM

182. Lack of somatic alterations of MC1R in primary melanoma (PubMed)

condition for melanocytes with specific somatic mutations to proliferate or survive, we analyzed 103 primary melanomas for somatic MC1R mutations and copy number alterations. This cohort included melanomas from skin with and without chronic sun-induced damage, mucosal membranes, and acral skin (palms, soles, and subungual). We did not find somatic mutations or frequent DNA copy number alterations at the MC1R locus, nor any skewed pattern of copy number alterations that would favor one allele type over (...) Lack of somatic alterations of MC1R in primary melanoma Germline variation of the melanocortin 1 receptor gene (MC1R) is a risk factor for cutaneous melanoma. Recent studies have indicated that the risk is significantly higher for melanomas with somatic BRAF mutations, suggesting that MC1R variants may have a more specific role than their demonstrated effects on skin and hair pigmentation. To address the possibility that MC1R may act like a tumor suppressor gene by creating a permissive

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2007 Pigment cell & melanoma research

183. Adjuvant, Combined Interleukin 2 (Proleukin) and DTIC (Dacarbazine) in High-risk Melanoma Patients

depth). When entering this study with recurrent regional lymph node disease, the patient must be enrolled no later than 90 days from the date of lymphadenectomy. For subungual melanomas a distal interphalangeal. amputation is required. For patients with regional lymph node recurrence, the same evidence for adequate margins around the primary are required as for patients at initial presentation. For safety reasons, patients must be of age between 18 and 85. Patients must have ECOG performance status (...) Adjuvant, Combined Interleukin 2 (Proleukin) and DTIC (Dacarbazine) in High-risk Melanoma Patients Adjuvant, Combined Interleukin 2 (Proleukin) and DTIC (Dacarbazine) in High-risk Melanoma Patients - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove

2007 Clinical Trials

184. Study of Families With Melanoma

: All Accepts Healthy Volunteers: Yes Criteria DISEASE CHARACTERISTICS: Meets 1 of the following criteria: Newly diagnosed primary invasive melanoma (patient group) Lentigo maligna malignant melanoma allowed Rare variants of melanoma allowed, including any of the following: Acral lentiginous Subungual Ear, nose, and throat Oropharyngeal Perineal Vaginal Vulval Rectal Nodal with no known primary Patients undergoing sentinel node biopsy are eligible No in situ melanoma, melanocytic intraepidermal (...) Study of Families With Melanoma Study of Families With Melanoma - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Study of Families With Melanoma The safety and scientific validity of this study

2007 Clinical Trials

185. Cutaneous melanoma in a multiethnic population: is this a different disease? (PubMed)

tumors (P<.001), more frequently had positive nodes (P =.004), and were at a more advanced stage (P =.002) than their white counterparts. The anatomic distribution between the 2 populations was significantly different (P<.001), with a high incidence of melanoma on the sole and subungual locations and a substantially less frequent occurrence on the head and neck, trunk, and extremities in the nonwhite population when compared with the white population. The overall survival rate of the nonwhite (...) Cutaneous melanoma in a multiethnic population: is this a different disease? Cutaneous melanoma in nonwhite persons has a manifestation and a prognosis that are different than those of cutaneous melanoma in white persons.Case series.Tertiary care university-affiliated community medical center located in a multiethnic state in which white persons are a minority of the population.Consecutive series of 357 patients with melanoma seen between January 1994 and August 2003.Ethnicity, age, sex

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2004 Archives of Surgery

186. Detection of micrometastasis in the sentinel lymph node via lymphoscintigraphy for a patient with in-transit metastatic melanoma. (PubMed)

basin status.The patient discussed here had a subungual melanoma that developed as an in-transit metastatic melanoma on the pretibia area 2 years after right big toe amputation. By using lymphoscintigraphy and SLN biopsy technique with injection of technetium-99m colloid around the in-transit metastatic site, the first node (SLN) draining the in-transit metastatic tumor was identified and harvested on the right inguinal area. Immediate right inguinal node dissection was subsequently performed.Under (...) Detection of micrometastasis in the sentinel lymph node via lymphoscintigraphy for a patient with in-transit metastatic melanoma. Lymphoscintigraphy and sentinel lymph node (SLN) biopsy are highly accurate methods of detecting regional lymph node status for melanoma. Previously, these procedures were mainly performed in patients with primary melanoma before wide local excision.To present a case with in-transit recurrence melanoma using lymphoscintigraphy and SLN biopsy for detection of nodal

2003 Dermatologic Surgery

187. Acral lentiginous melanoma mimicking benign disease: the Emory experience. (PubMed)

Acral lentiginous melanoma mimicking benign disease: the Emory experience. Plantar and subungual melanoma exhibits a higher misdiagnosis rate relative to other anatomic sites. Misdiagnosis and delay in diagnosis are statistically associated with poorer patient outcome. Awareness of atypical presentations of acral melanoma may, thus, be important to decrease misdiagnosis rates and improve patient outcome.We conducted a retrospective case review of plantar or lower-extremity subungual melanoma (...) performed at Winship Cancer Center, a tertiary care, referral center affiliated with Emory University, between 1985 and 2001.A total of 53 cases of plantar or lower-extremity subungual melanoma were identified. Of 53 cases with a final diagnosis of melanoma, 18 were initially misdiagnosed. Misdiagnoses included wart, callous, fungal disorder, foreign body, crusty lesion, sweat gland condition, blister, nonhealing wound, mole, keratoacanthoma, subungual hematoma, onychomycosis, ingrown toenail

2003 Journal of American Academy of Dermatology

188. Acral lentiginous melanoma: a clinicoprognostic study of 126 cases. (PubMed)

Acral lentiginous melanoma: a clinicoprognostic study of 126 cases. Although the histopathological subtype of melanoma has not been clearly proven to carry independent prognostic significance, acral lentiginous melanoma (ALM) seems to confer a poorer prognosis mainly because disease is often more advanced at the time of diagnosis.To investigate the distinctive epidemiological and clinical characteristics of ALM, a peculiar histological entity, and to identify prognostic factors.We performed (...) a register-based review of cases from a single large referral centre, the University Hospital Department of Dermatology, Lyons, France. We reviewed patient demographics, the initial presentation of the lesion, and clinical outcome. ALM-specific and disease-free survival were estimated using the KaplanMeier method and compared using the log-rank test. A Cox model was used to identify prognostic factors.One hundred and twenty-six patients were identified as having histopathology-proven ALM in our melanoma

2006 British Journal of Dermatology

189. Determinants of BRAF mutations in primary melanomas. (PubMed)

of 43 patients; P<.001, two-sided Fisher's exact test). By contrast, BRAF mutations in melanomas on chronically sun-damaged skin (1 of 12 patients) and melanomas on skin relatively or completely unexposed to sun, such as palms, soles, subungual sites (6 of 39 patients), and mucosal membranes (2 of 21 patients) are rare. We found no association of mutation status with clinical outcome or with the presence of an associated melanocytic nevus. The mutated BRAF allele was frequently found at an elevated (...) Determinants of BRAF mutations in primary melanomas. The RAS/mitogen-activated protein kinase pathway sends external growth-promoting signals to the nucleus. BRAF, a critical serine/threonine kinase in this pathway, is frequently activated by somatic mutation in melanoma. Using a cohort of 115 patients with primary invasive melanomas, we show that BRAF mutations are statistically significantly more common in melanomas occurring on skin subject to intermittent sun exposure than elsewhere (23

2003 Journal of the National Cancer Institute

190. High-Dose or Low-Dose Interferon Alfa Compared With No Further Therapy Following Surgery in Treating Patients With Stage III Melanoma

resection and lymphadenectomy with pathologically confirmed adequate surgical margins required Minimum 2 cm margin for primary lesions with Breslow depth greater than 2 mm Distal interphalangeal amputation required for subungual melanomas No primary melanoma originating apart from the skin No multiple in transit metastases in an extremity No lymph node involvement outside the operative area resected by radical neck, axillary lymph node, or ilioinguinal dissection PATIENT CHARACTERISTICS: Age: 16 to 75 (...) High-Dose or Low-Dose Interferon Alfa Compared With No Further Therapy Following Surgery in Treating Patients With Stage III Melanoma High-Dose or Low-Dose Interferon Alfa Compared With No Further Therapy Following Surgery in Treating Patients With Stage III Melanoma - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You

1999 Clinical Trials

191. Surgical management of primary cutaneous melanomas of the hands and feet. (PubMed)

of the melanoma.Data from 116 patients (39 men, 77 women) with melanomas of the hands (n = 26) and feet (n = 90) were evaluated. Pathologic diagnoses were: acral lentiginous melanoma (48 patients); subungual melanoma (13 patients), and skin of dorsum of the hand or foot (n = 55). Digital amputation was required in all 13 patients with subungual melanoma to maintain local control; still, nodal metastases developed in 46% of patients within 1 year. Seventy-one percent of patients with acral lentiginous melanoma (...) Surgical management of primary cutaneous melanomas of the hands and feet. The purpose of the study was to investigate the surgical management of cutaneous melanomas of the hands and feet.Prior studies suggest that patients with melanomes > 1-mm thick should be treated with excision with a 2-cm margin and undergo elective lymphadenectomy in selected circumstances. These recommendations are based primarily on data from melanomas of the trunk and extremities. Melanomas of the hands and feet

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1997 Annals of Surgery

192. Sentinel lymph-node biopsy after previous wide local excision for melanoma (PubMed)

rotation flap closures of truncal lesions. The third patient had a subungual melanoma of the great toe. No disease was found in the 2 nodes dissected. Two of the 3 false-negative biopsy results were obtained before serial sections and immunohistochemical staining were used to examine the sentinel lymph nodes.Sentinel lymph-node biopsies can successfully identify clinically occult nodal metastases in patients who have had previous wide local excision of a melanoma, but the false-negative rate (...) Sentinel lymph-node biopsy after previous wide local excision for melanoma To document experience with sentinel lymph-node biopsy in patients who have already undergone a wide local excision for melanoma because in many centres previous wide excision has been a contraindication for sentinel lymph-node biopsy.A prospective cohort study.A tertiary care academic cancer centre.One hundred patients who presented with cutaneous melanoma (depth >1 mm or Clark level IV) after having undergone wide

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2001 Canadian Journal of Surgery

193. Judging prognosis in malignant melanoma of the skin. A problem of inference over small data sets. (PubMed)

with melanoma of the palms and soles, subungual melanomas, and mucosal melanomas were excluded. A physician with a new melanoma patient could select the appropriate group for his or her patient, matched with respect to sex, location, and level, and then make a judgment regarding the prognosis, based on the survival experience of the group. In a few groups, the small numbers of patients provides only a rough impression of survival, but with many groups, a fair estimate can be made. The effectiveness (...) Judging prognosis in malignant melanoma of the skin. A problem of inference over small data sets. Data was generated for 828 clinical stage 1 melanoma patients, divided into groups according to sex, tumor location, and tumor level for each of the 56 groups. Summary data, including the number of patients, number of patients dying as a result of melanoma, range of tumor thickness, mean and median tumor thickness, and mean length of follow-up of the surviving patients, are shown. Patients

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1983 Annals of Surgery

194. Acral lentiginous melanoma. A clinicopathologic entity. (PubMed)

Acral lentiginous melanoma. A clinicopathologic entity. Acral lentiginous melanoma (ALM) is the fourth clinicopathologic variant of malignant melanoma. It occurs on volar surfaces of hands and feet, subungual sites, and fingers or toes. It is characterized by slow lentiginous radial growth and central plaque-like thickening, heavily pigmented tumor cells, markedly thickened papillary dermis, and diffuse reticular infiltration. Lesions are unusually large and, in most cases, thick and ulcerated (...) . There were 180 patients with acral melanoma (AM), which includes 67 in whom the specific features of ALM could be documented. One hundren sixty had primary lesions on ;the foot, and 20 occurred on the hand. There were 104 men and 76 women. There were 41 black patients and 139 whites. Five-year survivals following all modalities of therapy in 122 patients with Stage I acral melanoma is 63% for planter/palmar lesions, 58% for subungual lesions, and 27% for skin of digits. For the subgroup of Stage I

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1982 Annals of Surgery

195. A middle aged male diabetic has bilateral hallux subungual brown lesions not explained by trauma, mycology or ABPIs We are looking for a unitary diagnosis, but there may be alternatives?

male diabetic has bilateral hallux subungual brown lesions not explained by trauma, mycology or ABPIs We are looking for a unitary diagnosis, but there may be alternatives? Unfortunately, we cannot answer this query. We searched the NLH Specialist Libraries for Cancer, and Skin as well as the TRIP and Medline databases but found no information that might be used to manage a diabetic patient presenting with bilaterial hallux subungual lesions. Concerning the possibility of bilateral melanomas (...) A middle aged male diabetic has bilateral hallux subungual brown lesions not explained by trauma, mycology or ABPIs We are looking for a unitary diagnosis, but there may be alternatives? A middle aged male diabetic has bilateral hallux subungual brown lesions not explained by trauma, mycology or ABPIs We are looking for a unitary diagnosis, but there may be alternatives? - Trip Database or use your Google+ account Liberating the literature ALL of these words: Title only Anywhere in the document

2006 TRIP Answers

196. Subungual blue nevus. (PubMed)

Subungual blue nevus. Junctional or compound melanocytic nevus and melanoma may involve the nail apparatus and are usually discussed in the differential diagnosis of nail pigmentation. Blue nevus has been very rarely reported in this location. We report the second clinicopathologic study of a subungual blue nevus.

2003 Journal of American Academy of Dermatology

197. Regressed subungual melanoma simulating cellular blue nevus: managed with sentinel lymph node biopsy. (PubMed)

Regressed subungual melanoma simulating cellular blue nevus: managed with sentinel lymph node biopsy. Subungual melanoma, a not uncommon presentation of cutaneous melanoma in Asian populations, is easily overlooked as benign and thus is improperly treated.To present two cases with clinical suspicion of subungual melanoma. Skin biopsies failed to demonstrate the diagnostic features of malignancy.Lymphoscintigraphy and sentinel lymph node (SLN) biopsies were performed to determine regional lymph (...) node status.Both hematoxylin-eosin and HMB45 staining revealed melanoma cells in the SLN of the patient. The second patient's SLN was negative for malignant cells, but her excised primary lesion showed extensive regressed melanoma.Regression phenomena are not uncommon for subungual melanoma. An extention biopsy techniques are useful for determining nodal basin status in regressed subungual melanoma.

2006 Dermatologic Surgery

198. "Functional" surgery in subungual melanoma. (PubMed)

"Functional" surgery in subungual melanoma. Subungual melanomas represent approximately 2% to 3% of cutaneous melanomas in White populations. Complete or partial amputation proximal to the distal interphalangeal joint of the digits has been suggested. Recently, we introduced for acral melanomas, similar to lentigo maligna melanoma, limited excision and complete histology of excisional margins (three-dimensional histology).To evaluate the prognostic relevance of clinical parameters and different (...) surgical management in patients with subungual melanoma.From 1980 to 1999, subungual melanoma was diagnosed in 62 of 3,960 stage I and II melanoma patients (1.6%) of the melanoma registry of the Department of Dermatology (University of Tuebingen). A retrospective comparative analysis of two treatment groups was performed: Thirty-one patients had an amputation in or proximal to the distal interphalangeal joint (median follow-up of 55 months), and 31 patients had "functional" surgery with local excision

2003 Dermatologic Surgery

199. Subungual Melanoma: A Study of 124 Cases Highlighting Features of Early Lesions, Potential Pitfalls in Diagnosis, and Guidelines for Histologic Reporting. (PubMed)

Subungual Melanoma: A Study of 124 Cases Highlighting Features of Early Lesions, Potential Pitfalls in Diagnosis, and Guidelines for Histologic Reporting. Subungual melanoma (SUM) is an uncommon variant of melanoma that is often difficult to diagnose, both clinically and pathologically. In an attempt to provide pathologic clues to diagnosis, especially in early lesions or small biopsies, and to provide practical advice to pathologists in reporting, the clinicopathologic features of 124 cases (...) of SUM were reviewed, the largest series reported to date. The features of 28 cases of subungual melanoma in situ (MIS), comprising 4 cases of MIS and 24 cases where areas of MIS were present adjacent to dermal-invasive SUMs, were compared with those of a similar number of acral nevi to identify useful distinguishing features. The median age of the patients was 59 years and the most common site was the great toe (24%). Nine percent of cases were AJCC stage 0, 14% were stage I, 41% were stage II, 32

2007 American Journal of Surgical Pathology

200. Surgical management and prognostic factors in patients with subungual melanoma. (PubMed)

Surgical management and prognostic factors in patients with subungual melanoma. Forty-six cases of subungual melanoma were reviewed to identify significant clinicopathologic prognostic factors, determine the role of DNA content analysis in the biologic assessment of these tumors, and evaluate the effectiveness of amputation level, lymph node dissection (LND), and regional limb perfusion on the survival of these patients.Subungual melanoma is a unique and rare subtype of melanoma, constituting (...) only 1% to 3% of cases. Thus, little is known about prognostic factors and optimal management of patients with this disease. Moreover, the appropriate level of amputation and LND and limb perfusion in the management of subungual melanoma remain controversial.Forty-six patients underwent amputation alone or in combination with LND and/or regional limb perfusion for primary subungual melanoma. The effects of these treatment modalities and the prognostic significance of patient and tumor-related

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1994 Annals of Surgery

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