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Proximal nail plate destruction in subungual melanoma could be a possible predictor of invasiveness thicker than 1.25 mm
Authors:Jun Young Kim  Moon‐Bum Kim  Byung Cheol Park  Kee Yang Chung  You Chan Kim  Sook Jung Yun  Chong Hyun Won  Man‐Hoon Han  Won Kee Lee  Seok‐Jong Lee
Affiliation:1. Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea;2. Department of Dermatology, Pusan National University School of Medicine, Busan, Korea;3. Department of Dermatology, College of Medicine, Dankook University, Cheonan, Korea;4. Department of Dermatology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea;5. Department of Dermatology, Ajou University School of Medicine, Suwon, Korea;6. Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea;7. Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;8. Department of Pathology, Kyungpook National University School of Medicine, Daegu, Korea;9. Center of Biostatistics, Kyungpook National University School of Medicine, Daegu, Korea
Abstract:Various patterns of nail plate destruction are common features in subungual melanoma (SUM), but there has been no reports regarding their clinical significance according to the pattern of nail plate destruction in terms of tumor thickness. We tried to find a relationship between dermal invasion of SUM and proximal nail plate destruction (PNPD). Clinical information of patients with SUM was reviewed retrospectively from seven dermatology training hospitals in Korea. The PNPD was defined as a visible loss of full thickness of nail plate touching the eponychium at the most proximal part of it. We evaluated whether there are correlations between patients' age, sex, location of SUM, Breslow thickness (BT) and the presence of PNPD. Among 93 patients with SUM, 36 (38.7%) showed PNPD. Sex and BT showed significant correlations with the presence of PNPD in univariate analysis (P < 0.05). BT, age and sex showed significant correlations with the presence of PNPD in multivariate analysis (P < 0.05). Among them, BT showed the strongest correlation with the presence of PNPD (area under the curve, 0.722) and the cut‐off value was 1.25 mm. In conclusion, we suggest that PNPD in SUM could be a possible predictor of invasiveness of more than 1.25 mm BT.
Keywords:Breslow thickness  invasiveness  nail  proximal nail plate destruction  subungual melanoma
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