{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T16:24:18Z","timestamp":1791563058326,"version":"4.3.4"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Subungual amelanotic melanoma (SAM) poses significant diagnostic challenges due to its rarity and nonspecific clinical manifestations, such as nail dystrophy or indurated plaque.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>We present the case of a 60-year-old woman with a three-year history of recurrent serous drainage and persistent pain in her left middle finger following an initial crush injury. Over a period of two years, she underwent three nail avulsion procedures, received systemic antibiotic therapy, and was treated with topical Chinese herbal therapies under a presumptive diagnosis of \u201cchronic onychia following trauma\u201d at a local hospital. Additionally, PET-CT imaging demonstrated localized inflammatory changes without evidence of neoplastic disease. Despite these interventions, the lesion remained refractory to treatment. A thorough reevaluation conducted by our department, incorporating histopathological and immunohistochemical analyses, ultimately confirmed the diagnosis of SAM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This case underscores the importance of maintaining a high index of suspicion for SAM when evaluating atypical nail lesions. A low threshold for nail biopsy in cases of prolonged swelling and exudation of a single nail is advised. Additionally, prior trauma to the nail may contribute to the development of SAM through post-traumatic immunosuppression and persistent low-grade chronic inflammation. However, the exact role of trauma in the pathogenesis of melanoma remains unclear and requires further investigation.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2025.1661698","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T04:11:53Z","timestamp":1758859913000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Rare subungual amelanotic melanoma presenting as prolonged swelling and exudation after trauma: case report and literature 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