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Representative clinical morphology, photomicrographs of H&E staining, and IHC staining for cyclin D1 and PRAME of selected subunugal melanoma in situ. One 44-year-old patient (A) 2 mm-wide melanonychia showed (B) atypical melanocyte proliferation with confluency and pagetoid spread (200x magnification, H&E). Both (C) cyclin D1 and (D) PRAME IHC showed over 90% nuclear immunostaining (200x magnification, respectively), (E) Sox-10 IHC (200x magnification)

Representative clinical morphology, photomicrographs of H&E staining, and IHC staining for cyclin D1 and PRAME of selected subunugal melanoma in situ. One 44-year-old patient (A) 2 mm-wide melanonychia showed (B) atypical melanocyte proliferation with confluency and pagetoid spread (200x magnification, H&E). Both (C) cyclin D1 and (D) PRAME IHC showed over 90% nuclear immunostaining (200x magnification, respectively), (E) Sox-10 IHC (200x magnification)

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Background Distinguishing benign lesion from early malignancy in melanocytic lesions of the nail unit still remains a diagnostic challenge, both clinically and histopathologically. While several immunohistochemistry (IHC) stainings have been suggested to help discriminate benign subungual melanocytic proliferation (SMP) and subungual melanoma in si...