Last reviewed by Dr. Raj MD on January 12th, 2022.
What is Subungual Melanoma?
This is a very rare form of cancer and will typically occur on your big toe or thumb under the nail but can affect any nail on your foot. It is most commonly found in people who are of Asian and African-American descent. Of all melanoma cases this type accounts for only five percent.
You will usually see this type of cancer in people between the ages of sixty and seventy. This type of cancer is normally benign but can develop into cancer that can be deadly. Bob Marley, a famed musician, death was because of melanoma that began in his toenail.
Subungual Melanoma Symptoms
The symptoms of this type of cancer are usually hard to spot because of their location in a spot that is generally overlooked, especially if you are a person who likes to wear dark nail polish. Many people do not think about getting a melanoma under their nail so they do not really look for them.
Also, this type of cancer may look like you had just caused damage to the nail from an injury. Many times the first symptom of a subungual melanoma is a dark line that appears underneath your nail. In addition to the dark nail polish, another reason that most people do not see this first sign is that it happens to people who have dark skin. At this stage most of the lines are benign. In addition to the line, a person may also notice:
- A dark spot that can be purple, brown, or black in color.
- It can also appear as just a small lump under the nail with no color.
- As the melanocytes, which are the cells that produce melanin, a dark pigment that colors your skin and hair, will cause your nail to split. It can also cause your nail to rise up from your skin that is underneath.
- The cells may weep or bled but there is no pain.
If there is a new streak, or it changes color or shape you should see your physician immediately. Two other symptoms of an advance case of subungual melanoma are hyper-pigmentation of your skin or a nail bed that is damaged.
Subungual Melanoma Causes
There are three different types of cancer that can cause subungual melanomas, which are:
- Acral lentiginous melanoma – this is the most common type of cancer that causes this medical condition.
- Nodular melanoma
- Desmoplastic melanoma
It may also be caused by have a physical trauma to the nail may increase your risk of developing this type of cancer.
Typically the type of treatment to get rid of subungual melanoma is to have surgery but it really depends on what stage it is in and the how severe the center is. If it has not gone pass the depth of one millimeter wide all the physician will need to do is a local excision.
If it is wider than this your physician will need to do an excision along with a biopsy of your lymph node. If it is too advanced you may need to have the affected toe or finger surgically removed. If the surgery is not completely effective you may need to undergo chemotherapy, which uses medications that are cancer-killers to destroy the cancer cells.