Primary amelanotic melanoma of the nail bed

Introduction
Melanoma of the nail apparatus is rare in the Caucasian population and accounts for less than 1% of all diagnosed cases of melanoma. It most often derives from melanocytes of the nail unit matrix, while the bed of the nail is rarely the starting point.

Objective
Melanoma of the nail apparatus is rare in the Caucasian population and accounts for less than 1% of all diagnosed cases of melanoma. It most often derives from melanocytes of the nail unit matrix, while the bed of the nail is rarely the starting point.

Case report
We present a 64-year-old man with a history of immunosuppressive treatment because of pemphigus vulgaris. The patient developed a tumor of the nail bed of the left first toe. The nail plate was removed under regional anesthesia, revealing a pigment-free tumor of the nail bed, which was excised. Nail apparatus melanoma was diagnosed on the basis of the histopathological examination.

Conclusions
The presented case and the analysis of literature data prove the necessity of histopathological verification of each pathological mass occupying the bed of the nail unit.