The impact of hutchinson's nail sign on T-stage in subungual melanoma = The impact of hutchinson's nail sign on T-stage in subungual melanoma

다국어 초록 (Multilingual Abstract)

Background: Hutchinson's nail sign (HS) is an important clinical clue to diagnose subungual melanoma (SUM). However, there are rare studies about other clinical importance of HS in SUM.
Objectives: This study is to investigate the relationship between HS and clinicopathological features of SUM.
Methods: A retrospective study was conducted with 61 SUM patients from 2006 to 2017. We reviewed medical records and photographs of the patients.
Results: HS was seen in 46 (75.4%) of 61 SUM. The patients with HS showed ulceration more frequently (45.7%) and received sentinel lymph node biopsy (SLNB) more often (58.7%) than those without HS (13.3%, 26.7%). This tendency was also shown when HS exists on lateral nail folds (66.7% vs. 30.6% for ulceration, 83.3% vs. 42.9% for SLNB). The patients with HS on proximal nail fold or hyponychium showed nail changes more commonly (87.5%, 90.3%) than those without HS on those sites (62.1%, 60.0%). The patients with HS on 3 or 4 nail folds around the nail showed more frequent ulceration (66.7% vs. 30.6%), thicker Breslow thickness (2.52±3.03 mm vs. 1.46±2.80 mm), higher T-stage (≥2b, 66.7% vs. 30.6%) and higher stage (≥IIA, 66.7% vs. 30.6%) than those with HS on less than 3 nail folds around the nail.
Conclusion: HS correlated with some clinicopathological features of SUM. Especially, when the HS exists on 3 or 4 nail folds around the nail, we should consider that T-stage of SUM might be higher than expected.