Nail unit melanoma, also referred to as “subungual melanoma,” is a form of cutaneous melanoma that develops in the nail matrix [1–3]. Nail unit melanoma is associated with a poor prognosis, often attributed to late recognition of advanced disease. Reported five-year survival rates are 16–87%, depending on the extent of disease at diagnosis [4, 5]. Nail unit melanoma is distinct from acral lentiginous melanoma, as the former is more often associated with KIT and KRAS mutations, while the latter is more often associated with BRAF and NRAS mutations [6].