Subungual amelanotic melanoma: a diagnostic pitfall.

A 35 year old female presented with a persistent amelanotic lesion of the nail bed of the left great toe for 1 year, associated with destruction of the overlying nail. Incision biopsy revealed a nodular malignant melanoma and the toe was amputated. There is no sign of recurrence at 18 month follow-up. As prognosis is related to local disease extent, any persistent nail bed lesion should be biopsied to exclude the possibility of malignant melanoma.