Nail apparatus melanoma: a diagnostic opportunity
17-year-old female student from Manaus (Amazonas State), Fitzpatrick's phototype III,\npresented at the dermatology clinic with two ulcerated lesions. These were consistent\nwith leishmaniasis, both clinically and by lab (presence of Leshmania\nsp. amatigotes pattern on direct examination). Pentavalent antimonial was\nprescribed. During clinic follow-up, it was noted that the patient had a longitudinal\nmelanonychia on the right thumb (). On\nquestioning, she informed that this had been present for approximately one year. She\nalso reported family history of melanoma (great-aunt). Dermatoscopic examination\nrevealed lines varying in color from light brown to black, with different sizes, width\nand distances, with the most proximal area being more intense and thicker than the\ndistal area, forming a triangular shape (). Ungual matrix biopsy was performed by shaving. Histopathology was compatible\nwith melanoma in situ ().\nSurgical management involved excision of ungual apparatus up to periosteal region.\nFollowing histopathology no neoplasm showed in the 40 cuts made. Clinical staging was\nTisN0M0 (Stage 0). Patient followed up for 11 months without recurrence ().