Prevalence of subungual melanoma in patients with cutaneous malignant melanoma: A systematic review and meta-analysis
Corresponding Author
Aikaterini Tsiogka
Faculty of Medicine, First Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
Correspondence
Aikaterini Tsiogka, Hospital for Skin Diseases “A. Sygros”, 5 I. Dragoumi St. GR–16121 Athens, Greece.
Email: [email protected]
Search for more papers by this authorAdam I. Rubin
Department of Dermatology, Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Search for more papers by this authorStamatios Gregoriou
Faculty of Medicine, First Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
Search for more papers by this authorStergios Soulaidopoulos
First Department of Cardiology, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece
Search for more papers by this authorHelena Belyayeva
Faculty of Medicine, First Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
Search for more papers by this authorDimitris Rigopoulos
Faculty of Medicine, First Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
Search for more papers by this authorCorresponding Author
Aikaterini Tsiogka
Faculty of Medicine, First Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
Correspondence
Aikaterini Tsiogka, Hospital for Skin Diseases “A. Sygros”, 5 I. Dragoumi St. GR–16121 Athens, Greece.
Email: [email protected]
Search for more papers by this authorAdam I. Rubin
Department of Dermatology, Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Search for more papers by this authorStamatios Gregoriou
Faculty of Medicine, First Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
Search for more papers by this authorStergios Soulaidopoulos
First Department of Cardiology, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece
Search for more papers by this authorHelena Belyayeva
Faculty of Medicine, First Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
Search for more papers by this authorDimitris Rigopoulos
Faculty of Medicine, First Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
Search for more papers by this authorAbstract
Background
Subungual melanoma (SUM) is a rare type of cutaneous malignant melanoma (CMM) associated with poor prognosis, while data regarding its prevalence are scarce.
Objectives
We sought to provide a comprehensive systematic review and meta-analysis of the prevalence rates of SUM among all types of CMM, considering certain demographic and clinical characteristics.
Methods
The MEDLINE electronic database was searched systematically to identify eligible studies providing prevalence rate estimates of SUM in patients with CMM. Included studies were further analysed to estimate the relative prevalences of SUM according to study design, study years, geographical region and sex distribution.
Results
Twenty-eight studies met the inclusion criteria. The overall SUM prevalence was 1.9% (95% CI [1.5%–2.3%]). The prevalence of SUM did not differ significantly between population- and hospital-based studies and remained stable over time. However, it was found to be significantly higher in Asians compared to patients of other geographical regions as well as in studies with more men than women compared to those with female preponderance (p < 0.001).
Conclusions
In all, the overall SUM prevalence among all subtypes of CMM was estimated at 1.9%, without significant changes over time, and was found to exhibit significant variability between subgroups of different geographical regions.
CONFLICT OF INTEREST STATEMENT
The authors declare no conflict of interest.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from the corresponding author, [AT], upon reasonable request.
Supporting Information
| Filename | Description |
|---|---|
| jdv19482-sup-0001-FigureS1.tiffTIFF image, 1.1 MB |
Figure S1. |
| jdv19482-sup-0002-FigureS2.pngPNG image, 237.4 KB |
Figure S2. |
| jdv19482-sup-0003-FigureS3.pngPNG image, 219.9 KB |
Figure S3. |
| jdv19482-sup-0004-FigureS4.pngPNG image, 267.2 KB |
Figure S4. |
| jdv19482-sup-0005-FigureS5.pngPNG image, 126.9 KB |
Figure S5. |
| jdv19482-sup-0006-TableS1.docxWord 2007 document , 21.4 KB |
Table S1. |
| jdv19482-sup-0007-TableS2.docxWord 2007 document , 13.7 KB |
Table S2. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
REFERENCES
- 1Huang K, Fan J, Misra S. Acral lentiginous melanoma: incidence and survival in the United States, 2006-2015, an analysis of SEER registry. J Surg Res. 2020; 251: 329–339.
- 2Memon A, Bannister P, Rogers I, Sundin J, al-Ayadhy B, James PW, et al. Changing epidemiology and age-specific incidence of cutaneous malignant melanoma in England: an analysis of the national cancer registration data by age, gender and anatomical site, 1981–2018. Lancet Reg Health Eur. 2021; 2:100024.
- 3Bradford PT, Goldstein AM, McMaster ML, Tucker MA. Acral lentiginous melanoma: incidence and survival patterns in the United States, 1986-2005. Arch Dermatol. 2009; 145: 427–434.
- 4Mejbel HA, Torres-Cabala CA, Milton DR, Ivan D, Nagarajan P, Curry JL, et al. Prognostic significance of subungual anatomic site in Acral lentiginous melanoma. Arch Pathol Lab Med. 2020; 145: 943–952.
- 5Holman BN, Van Gulick RJ, Amato CM, MacBeth ML, Davies KD, Aisner DL, et al. Clinical and molecular features of subungual melanomas are site-specific and distinct from acral melanomas. Melanoma Res. 2020; 30: 562–573.
- 6Wei X, Wu D, Li H, Zhang R, Chen Y, Yao H, et al. The Clinicopathological and survival profiles comparison across primary sites in Acral melanoma. Ann Surg Oncol. 2020; 27: 3478–3485.
- 7Banfield CC, Redburn JC, Dawber RP. The incidence and prognosis of nail apparatus melanoma. A retrospective study of 105 patients in four English regions. Br J Dermatol. 1998; 139: 276–279.
- 8Alani A, Blasdale C, Oliphant T, Hackett C, Langtry JAA. The causes of nail apparatus pigmentation presenting to a melanoma screening clinic a prospective study. Clin Exp Dermatol. 2019; 44: 625–630.
- 9Borkowska AM, Szumera-Ciećkiewicz A, Spałek MJ, Teterycz P, Czarnecka AM, Rutkowski PŁ. Clinicopathological features and prognostic factors of primary Acral melanomas in Caucasians. J Clin Med. 2020; 9:2996.
- 10Collins R. Melanoma in the Chinese of Hong Kong. Emphasis on volar and subungual sites. Cancer. 1984; 54: 1482–1488.
10.1002/1097-0142(19841001)54:7<1482::AID-CNCR2820540745>3.0.CO;2-O CAS PubMed Web of Science® Google Scholar
- 11Csanyi I, Houshmand N, Szücs M. Acral lentiginous melanoma: a single-center retrospective review of four decades in east- Central Europe. J Eur Acad Dermatol Venereol. 2020; 34: 2004–2010.
- 12Das Gupta T, Brasfield R. Subungual melanoma: a 25-year review of cases. Ann Surg. 1965; 161: 545–552.
- 13Dika E, Patrizi A, Fanti PA, Chessa MA, Reggiani C, Barisani A, et al. The prognosis of nail apparatus melanoma: 20 years of experience from a single institute. Dermatology. 2016; 232: 177–184.
- 14Gutman M, Klausner JM, Inbar M, Skornick Y, Baratz M, Rozin RR. Acral (volar-subungual) melanoma. Br J Surg. 1985; 72: 610–613.
- 15Hudson DA, Krige JE. Melanoma in black south Africans. J Am Coll Surg. 1995; 180: 65–71.
- 16Ikeda S, Kiyohara Y, Mizutani H. Comparative aspects of melanoma and non-melanoma skin cancers in Japan. J Invest Dermatol. 1989; 92(5 Suppl): 204S–209S.
- 17Kato T, Suetake T, Sugiyama Y, Tabata N, Tagami H. Epidemiology and prognosis of subungual melanoma in 34 Japanese patients. Br J Dermatol. 1996; 134: 383–387.
- 18Klausner JM, Inbar M, Gutman M, Weiss G, Skornick Y, Chaichik S, et al. Nail-bed melanoma. J Surg Oncol. 1987; 34: 208–210.
- 19Krementz ET, Feed RJ, Coleman WP 3rd, Sutherland CM, Carter RD, Campbell M. Acral lentiginous melanoma. A clinicopathologic entity. Ann Surg. 1982; 195: 632–645.
- 20Krige JE, Hudson DA, Johnson CA, King HS, Chetty R. Subungual melanoma. S Afr J Surg. 1995; 33: 10–14.
- 21Kuchelmeister C, Schaumburg-Lever G, Garbe C. Acral cutaneous melanoma in caucasians: clinical features, histopathology and prognosis in 112 patients. Br J Dermatol. 2000; 143: 275–280.
- 22Milton GW, Shaw HM, McCarthy WH. Subungual malignant melanoma: a disease entity separate from other forms of cutaneous melanoma. Australas J Dermatol. 1985; 26: 61–64.
- 23Nunes LF, Mendes GLQ, Koifman RJ. Subungual melanoma: a retrospective cohort of 157 cases from Brazilian National Cancer Institute. J Surg Oncol. 2018; 118: 1142–1149.
- 24Ozdemir F, Errico MA, Yaman B, Karaarslan I. Acral lentiginous melanoma in the Turkish population and a new dermoscopic clue for the diagnosis. Dermatol Pract Concept. 2018; 8: 140–148.
- 25Reyes E, Uribe C, de Vries E. Population-based incidence and melanoma-specific survival of cutaneous malignant melanoma in a Colombian population 2000–2009. Int J Dermatol. 2018; 57: 21–27.
- 26Rigby HS, Briggs JC. Subungual melanoma: a clinico-pathological study of 24 cases. Br J Plast Surg. 1992; 45: 275–278.
- 27Saida T, Ohshima Y. Clinical and histopathologic characteristics of early lesions of subungual malignant melanoma. Cancer. 1989; 63: 556–560.
10.1002/1097-0142(19890201)63:3<556::AID-CNCR2820630326>3.0.CO;2-Q CAS PubMed Web of Science® Google Scholar
- 28Shaw JH, Koea JB. Acral (volar-subungual) melanoma in Auckland, New Zealand. Br J Surg. 1988; 75: 69–72.
- 29Slingluff CLJ, Vollmer R, Seigler HF. Acral melanoma: a review of 185 patients with identification of prognostic variables. J Surg Oncol. 1990; 45: 91–98.
- 30Takematsu H, Obata M, Tomita Y, Kato T, Takahashi M, Abe R. Subungual melanoma. A clinicopathologic study of 16 Japanese cases. Cancer. 1985; 55: 2725–2731.
10.1002/1097-0142(19850601)55:11<2725::AID-CNCR2820551134>3.0.CO;2-V CAS PubMed Web of Science® Google Scholar
- 31Talavera-Belmonte A, Bonfill-Ortí M, Martínez-Molina L, Fornons-Servent R, Bauer-Alonso A, Ferreres-Riera JR, et al. Subungual melanoma: a descriptive study of 34 patients. Actas Dermosifiliogr. 2018; 109: 801–806.
- 32Tuominen L, Strengell L. Melanoma of palms, soles, and nail-beds. Scand J Plast Reconstr Surg Hand Surg. 1992; 26: 287–292.
- 33Wee E, Wolfe R, Mclean C, Kelly JW, Pan Y. The anatomic distribution of cutaneous melanoma: a detailed study of 5141 lesions. Australas J Dermatol. 2020; 61: 125–133.
- 34Wollina U, Tempel S, Hansel G. Subungual melanoma: a single center series from Dresden. Dermatol Ther. 2019; 32:e13032.
- 35Haneke E. Ungual melanoma - controversies in diagnosis and treatment. Dermatol Ther. 2012; 25: 510–524.
- 36Wu XC, Eide MJ, King J, Saraiya M, Huang Y, Wiggins C, et al. Racial and ethnic variations in incidence and survival of cutaneous melanoma in the United States, 1999-2006. J Am Acad Dermatol. 2011; 65: S26.e1–S26.e13.
- 37Lee WJ, Lee JH, Won CH, Chang SE, Choi JH, Moon KC, et al. Nail apparatus melanoma: a comparative, clinicoprognostic study of the initial clinical and morphological characteristics of 49 patients. J Am Acad Dermatol. 2015; 73: 213–220.
- 38Kostaki M, Plaka M, Stergiopoulou A, Kypreou K, Chardalia V, Befon A, et al. Subungual melanoma: the experience of a Greek melanoma reference Centre from 2003 to 2018. J Eur Acad Dermatol Venereol. 2020; 34: e231–e234.
- 39Cohen T, Busam KJ, Patel A, Brady MS. Subungual melanoma: management considerations. Am J Surg. 2008; 195: 244–248.
- 40Huayllani MT, Restrepo DJ, Boczar D, Avila FR, Bagaria SP, Spaulding AC, et al. National Comprehensive Analysis of characteristics of Acral lentiginous melanoma. Anticancer Res. 2020; 40: 3411–3415.
- 41Minagawa A, Omodaka T, Koga H, Yokokawa Y, Uhara H, Okuyama R. Nail apparatus melanoma thickness is associated with side and age. Br J Dermatol. 2017; 177: e65–e66.
- 42Metzger S, Ellwanger U, Stroebel W, Schiebel U, Rassner G, Fierlbeck G. Extent and consequences of physician delay in the diagnosis of acral melanoma. Melanoma Res. 1998; 8: 181–186.
- 43Benati E, Ribero S, Longo C, Piana S, Puig S, Carrera C, et al. Clinical and dermoscopic clues to differentiate pigmented nail bands: an international Dermoscopy society study. J Eur Acad Dermatol Venereol. 2017; 31: 732–736.
- 44Chakera AH, Quinn MJ, Lo S, Drummond M, Haydu LE, Bond JS, et al. Subungual melanoma of the hand. Ann Surg Oncol. 2019; 26: 1035–1043.
- 45Howard M, Xie C, Wee E, Wolfe R, McLean C, Kelly JW, et al. Acral lentiginous melanoma: Clinicopathologic and survival differences according to tumour location. Australas J Dermatol. 2020; 61: 312–317.
- 46Phan A, Touzet S, Dalle S, Ronger-Savlé S, Balme B, Thomas L. Acral lentiginous melanoma: a clinicoprognostic study of 126 cases. Br J Dermatol. 2006; 155: 561–569.
- 47Lieberherr S, Cazzaniga S, Haneke E, Hunger RE, Seyed Jafari SM. Melanoma of the nail apparatus: a systematic review and meta-analysis of current challenges and prognosis. J Eur Acad Dermatol Venereol. 2020; 34: 967–976.
