Subungual Melanoma in Negroes
Melanotic tumors of all types are very rare in the Negro. Adair, Pack, and Nicholson1 in a review of the literature on this subject found fourteen reported cases up to 1926. One of three cases of subungual melanoma which these authors observed at Memorial Hospital occurred in a Negro. In 1927 Bauer2 reported two cases of melanotic tumors occurring in Negroes, one of which was a subungual melanoma. We can now add a further case to those already reported.
A Negress, seventy-three years of age, came to the Cleveland Clinic complaining of discoloration of the fifth finger of the left hand. The following history was obtained: For twenty years she had had a “black spot” on the nail of the fifth finger of the left hand. This spot grew gradually larger and another developed, so that there were two large discolored areas on the nail, both quite black in color. This condition had remained constant for the past fifteen years, during which time the area of discoloration had not increased in size. Six months previous to the admission of the patient, the nail split, assuming a bifid character. Up to that time the nail had been normal in shape and configuration (Fig. I).
Physical examination of the patient revealed nothing abnormal apart from the black discoloration of the fifth finger of the left hand, including the nail which was bifid due to a splitting down its centre as far as the nail bed. Pus could be evacuated from the central. . .