Nail unit melanoma

NUM can resemble nodular melanomas, appearing suddenly as an ulcerated nodule that grows quickly. 2 NUM is usually misdiagnosed and notoriously mimics other tumors (such as periungual pyogenic granuloma in our case). Herein we are presenting a rare case of nail unit melanoma in a 52-year-old female who presented with insidious onset, slowly progressive soft to firm, non-tender, red nodule with a proximal nail fold showing bluish-black pigmentation over the left thumb area associated with bleeding since 1 year. Histopathology and immunohistochemistry are suggestive of melanoma. Surgical oncology reference was sought and digital amputation was considered.