Cancer of the Nail Bed

To the Editor.—  The article on squamous cell carcinoma of the nail bed by Long and Espiniella states that a review of the literature on primary nail-bed malignant neoplasms disclosed a total of only 53 reported cases, the majority of which were squamous cell carcinomas, with the remainder consisting of Bowen's disease and basal cell carcinomas.I believe that this statement should be corrected, since malignant melanomas unquestionably are the most frequent malignant tumors of this region. Although subungual lesions make up only 2% to 3% of all malignant melanomas, there are reports of many more than 53 cases of primary melanomas of the nail bed. For example, one series reported by Pack and Oropeza¹ described 72 patients with such lesions. Furthermore, contrary to the article in JAMA that states that squamous cell carcinoma is the most serious of the primary nail-bed tumors, there is ample evidence that melanomas