title: "Hitting the nail on the head".
abstract: Subungual malignant melanoma is a rare form of malignancy that can present at an advanced stage. We describe a case that was diagnosed after a presentation to the emergency department for a traumatic injury of the affected area. Initial presentations of malignant disease and its complications form a relatively low proportion of the caseload of emergency doctors. In this case, a patient presented after a minor injury that had failed to recover; subsequent investigation of this injury led to the diagnosis of subungual malignant melanoma in an otherwise asymptomatic patient. This is a rare case which presented in an atypical fashion, with a confounding history of minor trauma. It is presented to highlight the differential diagnosis of destructive bone lesions.
authors.affiliation: The Sickbay, 42 Commando Royal Marines, Bickleigh Barracks, Plymouth, UK.
authors.forename: A
authors.initials: A
authors.lastname: Fries
authors.forename: I
authors.initials: I
authors.lastname: Higginson
mesh_terms: D004630:Emergencies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis*; D009260:Nail Diseases / Q000175:diagnosis*; D009262:Nails / Q000293:injuries*; D012878:Skin Neoplasms / Q000175:diagnosis*; D014949:Wounds, Nonpenetrating / Q000473:pathology*