Subungual melanoma: a case report of delayed diagnosis despite multiple biopsies

Subungual melanoma is a rare presentation of melanoma, accounting for approximately 3% of all cases of this neoplasm.In this case, the diagnosis was only confirmed after the third biopsy, highlighting the importance of suspecting malignancy based on clinical history and dermatological examination.This report describes the case of a 43-year-old female patient with longitudinal melanonychia on the first and third digits of the right hand.She had undergone two previous biopsies, both showing no evidence of malignancy on histopathological analysis.However, due to high clinical suspicion, a third biopsy was performed, confirming a diagnosis of subungual melanoma in situ.In most cases, the prognosis is poor, with frequent bone metastases.The rarity of this melanoma presentation, combined with the diagnostic challenges and the low survival rate, justifies the report of this case.

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Publication Details

Journal
Portuguese Journal of Dermatology and Venereology
Published
2026-04-15
DOI
https://doi.org/10.24875/pjdv.26000018
Primary Topic
Cutaneous Melanoma Detection and Management
Type
article
Field-Weighted Citation Impact
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article

Subungual melanoma: a case report of delayed diagnosis despite multiple biopsies

Luciana Mendes-dos Santos, Rebeca Martins, Daniela Vale-Dias, Aline Guimarães-Grana et al.
Portuguese Journal of Dermatology and Venereology
Cutaneous Melanoma Detection and Management
article

Subungual melanoma: a case report of delayed diagnosis despite multiple biopsies

Luciana Mendes-dos Santos, Rebeca Martins, Daniela Vale-Dias, Aline Guimarães-Grana, Bruna R. Santana-Vollrath, Thalyssa Figueiredo-Magalhães, Vanessa R. Ferreira
article en

Abstract

Subungual melanoma is a rare presentation of melanoma, accounting for approximately 3% of all cases of this neoplasm.In this case, the diagnosis was only confirmed after the third biopsy, highlighting the importance of suspecting malignancy based on clinical history and dermatological examination.This report describes the case of a 43-year-old female patient with longitudinal melanonychia on the first and third digits of the right hand.She had undergone two previous biopsies, both showing no evidence of malignancy on histopathological analysis.However, due to high clinical suspicion, a third biopsy was performed, confirming a diagnosis of subungual melanoma in situ.In most cases, the prognosis is poor, with frequent bone metastases.The rarity of this melanoma presentation, combined with the diagnostic challenges and the low survival rate, justifies the report of this case.

Portuguese Journal of Dermatology and Venereology
Openalex Percentile: Top 8%
Cutaneous Melanoma Detection and Management
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Subungual melanoma: a case report of delayed diagnosis despite multiple biopsies — Luciana Mendes-dos Santos, Rebeca Martins, et al. · Portuguese Journal of Dermatology and Venereology (2026) | TGRS Research Map | TGRS