Predictor of Subungual Melanoma against Benign Longitudinal Melanonychia: A Retrospective Cohort Study from Korea
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초록
Background: Longitudinal melanonychia (LM) is a common clinical finding. Most cases of LM are benign, and a waitand- see approach is preferred in the management of this condition. Nevertheless, it is important for clinicians to distinguish subungual melanoma (SUM) from other benign LMs. Objective: To evaluate the demographic and clinicopathologic characteristics of LM in the Korean population and to identify the predictor of SUM against other benign conditions. Methods: This was a single-center retrospective cohort study including patients who underwent nail biopsy for LM from January 2000 to May 2019. To identify the predictor of SUM, receiver operating characteristic (ROC) analyses was performed. Results: A total of 68 cases of biopsy-proven LM were included in the analysis. Among the 68 cases, 8 were SUM. In univariable analysis, patients diagnosed with SUM were older (p=0.035) and had a longer disease duration (p=0.004). They also showed multicolor pigmentation of LM (p=0.022), a larger width of LM (p＜0.001), and associated nail plate dystrophy (p=0.010) than patients diagnosed with benign conditions. In multivariable logistic regression, width of LM showed statistical significance (odds ratio, 1.083; 95% confidence interval, 1.018∼1.153). ROC analysis suggested that an LM width ＞28% of the whole nail was the predictor of SUM (area under the curve=0.883; p＜0.001). Conclusion: SUM has distinct demographic and clinical features. The width of LM can predict SUM against other benign LMs.
Abstract
Background: Longitudinal melanonychia (LM) is a common clinical finding. Most cases of LM are benign, and a waitand- see approach is preferred in the management of this condition. Nevertheless, it is important for clinicians to distinguish subungual melanoma (SUM) from other benign LMs. Objective: To evaluate the demographic and clinicopathologic characteristics of LM in the Korean population and to identify the predictor of SUM against other benign conditions. Methods: This was a single-center retrospective cohort study including patients who underwent nail biopsy for LM from January 2000 to May 2019. To identify the predictor of SUM, receiver operating characteristic (ROC) analyses was performed. Results: A total of 68 cases of biopsy-proven LM were included in the analysis. Among the 68 cases, 8 were SUM. In univariable analysis, patients diagnosed with SUM were older (p=0.035) and had a longer disease duration (p=0.004). They also showed multicolor pigmentation of LM (p=0.022), a larger width of LM (p＜0.001), and associated nail plate dystrophy (p=0.010) than patients diagnosed with benign conditions. In multivariable logistic regression, width of LM showed statistical significance (odds ratio, 1.083; 95% confidence interval, 1.018∼1.153). ROC analysis suggested that an LM width ＞28% of the whole nail was the predictor of SUM (area under the curve=0.883; p＜0.001). Conclusion: SUM has distinct demographic and clinical features. The width of LM can predict SUM against other benign LMs.
참고문헌 (13)
- Leung AKC, "Melanonychia striata: clarifying behind the Black Curtain. A review on clinical evaluation and management of the 21st century", Int J Dermatol, 58, pp.1239~1245 (2019)
- Ko D, "Retrospective singlecenter study evaluating clinical and dermoscopic features of longitudinal melanonychia, ABCDEF criteria, and risk of malignancy", J Am Acad Dermatol, 80, pp.1272~1283 (2019)
- Jiyad Z, "Incidence of melanoma and outcomes of longitudinal melanonychia in a cohort of cases referred to a London dermatology department", Br J Dermatol, 181, pp.204~205 (2019)
- Haneke E, "Ungual melanoma-controversies in diagnosis and treatment", Dermatol Ther, 25, pp.510~524 (2012)
- 이재호, "Early Detection of Subungual Melanoma In Situ: Proposal of ABCD Strategy in Clinical Practice Based on Case Series", Annals of Dermatology, 30(1), pp.36~40 (2018), 대한피부과학회
- Saida T, "Clinical and histopathologic characteristics of early lesions of subungual malignant melanoma", Cancer, 63, pp.556~560 (1989)
- Levit EK, "The ABC rule for clinical detection of subungual melanoma", J Am Acad Dermatol, 42(2 Pt 1), pp.269~274 (2000)
- Chakera AH, "Subungual melanoma of the hand", Ann Surg Oncol, 26, pp.1035~1043 (2019)
- André J, "Pigmented nail disorders", Dermatol Clin, 24, pp.329~339 (2006)
- Goettmann-Bonvallot S, "Longitudinal melanonychia in children : a clinical and histopathologic study of 40 cases", J Am Acad Dermatol, 41, pp.17~22 (1999)
- Ohn J, "Dermoscopic features of nail matrix nevus(NMN)in adults and children : a comparative analysis", J Am Acad Dermatol, 75, pp.535~540 (2016)
- Krementz ET, "Malignant melanoma in the American Black", Ann Surg, 183, pp.533~542 (1976)
- Ohn J, "Assessment of a predictive scoring model for dermoscopy of subungual melanoma in situ", JAMA Dermatol, 154, pp.890~896 (2018)