The spectrum of malignant melanoma of the nail apparatus.

Unlike most morphological types of malignant melanoma, that of the nail apparatus is relatively rare--only 2% to 3% of one series. Although in the case of blacks and orientals, the incidence of malignant melanoma of the nail apparatus is proportionately more common. However, it is a serious disease with poor 5-year survival figures in the published series--21% to 50%. This poor prognosis may be an intrinsic function of the site and of other parts of the body, but the lateness of diagnosis in many of the published cases is of far more significance. In malignant melanoma at other body sites, late diagnosis usually relates to the patient not presenting early in the course of the disease; this may also apply to nail malignant melanoma. However, the frequency of failure of the first line physician or surgeon to recognize the clinical signs or to perform a biopsy from the correct site to obtain an accurate diagnosis is far more important.