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Emergency Medicine Journal 2007;24:e3; doi:10.1136/emj.2006.041061
© 2007 BMJ Publishing Group Ltd and the College of Emergency Medicine.

EMERGENCY CASEBOOK

"Hitting the nail on the head"

A Fries1, I Higginson2

1 The Sickbay, 42 Commando Royal Marines, Bickleigh Barracks, Plymouth, UK
2 Derriford Hospital, Plymouth, UK

Correspondence to:
Correspondence to:
Dr I Higginson
Emergency Department, Derriford Hospital, Plymouth PL6 8DH, UK; ian.higginson{at}phnt.swest.nhs.uk

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.


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Official journal of British Association for Immediate Care: BASICS, Faculty of Pre-Hospital Care, Irish Society for Immediate Care and Swedish Society for Emergency Medicine: SweSEM

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