› Forums › General Melanoma Community › Subungual Melanoma?
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- June 10, 2016 at 4:56 pm
So I had a single dark stripe appear down the center of my toenail 6 years ago. It slowly expanded toward the edge of my toe. Id asked my Dr about it a couple times but they never seemed particularly concerned. Upon moving and seeing a new provider about a different issue, he noticed it and referred me to a dermatologist who wanted to biopsy it immediately. He called a couple weeks later and said everything came back “fine”, being naive I accepted that explanation. He said all color was removed and the nail should grow back weird since he cut into the nail matrix to biopsy, but the color should be gone. If the color grows back I should return to the dermatologist.The nail grew back with no color. That was November 2012. Starting in probably summer 2014 I noticed some color coming back on the edge of the nail. I figured it was dirt under the nail due to being misshapen. By spring 2015 I could tell it was definitely color growing back. Saw a new dermatologist. She was hesitant to biopsy again unless it grew past its original parameters. Moved this past year. Noticed it did in fact grow past the initial parameters. Just went to get it checked and biopsied yesterday.
Any hints or advice you could share based off of picture?
If it was a melanoma, how is that possible after dealing with it for 6+ years?
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- June 10, 2016 at 5:17 pm
I don't know a lot about this type of melanoma, but back in October half of my big toenail had become black, like a bruise, except I didn't hurt my toe at all so I saw my doctor about it and she had the dermatologist look at it. The dermatologist was looking for the black color to have spread onto my skin and not just the nail. He said it had not spread onto the skin around the nail, so it was just a bruise, it has since grown out and was a mysterious bruise. Just happened at the same time to show the derm a super ugly mole that had been growing on my calf.. had that biposied and, well, that's why I am here. I call it the bruise that possibly saved my life. Anyway, maybe ask the derm if they're not worried because the dark color has not spread to the surrounding skin? I think there might be others on here who've had this type of mel and might have more insight for you, but wanted to give you what I've experienced.
All the best,
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- June 10, 2016 at 5:17 pm
I don't know a lot about this type of melanoma, but back in October half of my big toenail had become black, like a bruise, except I didn't hurt my toe at all so I saw my doctor about it and she had the dermatologist look at it. The dermatologist was looking for the black color to have spread onto my skin and not just the nail. He said it had not spread onto the skin around the nail, so it was just a bruise, it has since grown out and was a mysterious bruise. Just happened at the same time to show the derm a super ugly mole that had been growing on my calf.. had that biposied and, well, that's why I am here. I call it the bruise that possibly saved my life. Anyway, maybe ask the derm if they're not worried because the dark color has not spread to the surrounding skin? I think there might be others on here who've had this type of mel and might have more insight for you, but wanted to give you what I've experienced.
All the best,
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- June 10, 2016 at 5:17 pm
I don't know a lot about this type of melanoma, but back in October half of my big toenail had become black, like a bruise, except I didn't hurt my toe at all so I saw my doctor about it and she had the dermatologist look at it. The dermatologist was looking for the black color to have spread onto my skin and not just the nail. He said it had not spread onto the skin around the nail, so it was just a bruise, it has since grown out and was a mysterious bruise. Just happened at the same time to show the derm a super ugly mole that had been growing on my calf.. had that biposied and, well, that's why I am here. I call it the bruise that possibly saved my life. Anyway, maybe ask the derm if they're not worried because the dark color has not spread to the surrounding skin? I think there might be others on here who've had this type of mel and might have more insight for you, but wanted to give you what I've experienced.
All the best,
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- June 10, 2016 at 9:26 pm
I appreciate your concern. The nail would worry the heck of of me, it looks too much like the left hand side picture on this page:
http://www.dermnetnz.org/hair-nails-sweat/melanoma-nailunit.html
It is pigmented, changing, different colours, wider at the cuticle end than top end. That's enough of the worrying signs to justify the biopsy you got. I think you have done exactly the right thing here, you needed to get this biopsy.
All that said, the more likely diagnosis is this:
http://www.dermnetnz.org/hair-nails-sweat/melanonychia.html
Why don't you ring the derm who did original biopsy and get a copy of that biopsy report? Then you'll know what it was, and what it most likely is this time.
But either way, that biopsy is needed to rule out melanoma of the nail bed/matrix.
FWIW, I think if it's been six years in the making, there would be alot more destruction if it was melanoma (ulceration etc). This hasn't happened, so I'm thinking and hoping that it's the benign condition melanonychia. Either way though, the monitoring and biopsy is a smart move.
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- June 10, 2016 at 11:25 pm
Thanks for the information. I figured same as you that were it a melanoma, after 6 years, younwould think there’d be more progression. I just couldnt find any certain alternative possibilities. So thanks. I was concerned because it does look like many pics of of melanomas I could find online.Another question, after removing the nail for biopsy, we discovered that there were spots of discoloration on the bed below the nail too. She removed some of that for analysis too. Those werent there when last biopsied 4 years ago. Is that concerning?
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- June 11, 2016 at 8:47 am
Let's focus on that: six years of progression would more than likely involve much more destruction. If a melanoma was removed six years ago, the biopsy would show that and you wouldn't have a big toe anymore, it would have been amputated way back when.
It seems that the pigmentation then – and most likely now – is not melanoma. Remember on this page:
http://www.dermnetnz.org/hair-nails-sweat/melanonychia.html
It says that:
"Melanonychia is a common condition characterised by brown to black discolouration of the nail. It most frequently arises from benign conditions, such as a pigmented melanocytic naevus"
You could have this pigmented lesion in the nailbed, but not a melanoma. A more disturbing thing would be extension of the pigment into the nail fold (skin around the nail) – this doesn't appear to be the case.
Anyway, you are doing what you can do, hang in there until you get 'the call' and hopefully it's all good news. If not, you've done all you can do – I mean, you had this thing biopsied years ago. What more could you have possibly done?
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- June 11, 2016 at 8:47 am
Let's focus on that: six years of progression would more than likely involve much more destruction. If a melanoma was removed six years ago, the biopsy would show that and you wouldn't have a big toe anymore, it would have been amputated way back when.
It seems that the pigmentation then – and most likely now – is not melanoma. Remember on this page:
http://www.dermnetnz.org/hair-nails-sweat/melanonychia.html
It says that:
"Melanonychia is a common condition characterised by brown to black discolouration of the nail. It most frequently arises from benign conditions, such as a pigmented melanocytic naevus"
You could have this pigmented lesion in the nailbed, but not a melanoma. A more disturbing thing would be extension of the pigment into the nail fold (skin around the nail) – this doesn't appear to be the case.
Anyway, you are doing what you can do, hang in there until you get 'the call' and hopefully it's all good news. If not, you've done all you can do – I mean, you had this thing biopsied years ago. What more could you have possibly done?
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- June 11, 2016 at 8:47 am
Let's focus on that: six years of progression would more than likely involve much more destruction. If a melanoma was removed six years ago, the biopsy would show that and you wouldn't have a big toe anymore, it would have been amputated way back when.
It seems that the pigmentation then – and most likely now – is not melanoma. Remember on this page:
http://www.dermnetnz.org/hair-nails-sweat/melanonychia.html
It says that:
"Melanonychia is a common condition characterised by brown to black discolouration of the nail. It most frequently arises from benign conditions, such as a pigmented melanocytic naevus"
You could have this pigmented lesion in the nailbed, but not a melanoma. A more disturbing thing would be extension of the pigment into the nail fold (skin around the nail) – this doesn't appear to be the case.
Anyway, you are doing what you can do, hang in there until you get 'the call' and hopefully it's all good news. If not, you've done all you can do – I mean, you had this thing biopsied years ago. What more could you have possibly done?
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- June 10, 2016 at 11:25 pm
Thanks for the information. I figured same as you that were it a melanoma, after 6 years, younwould think there’d be more progression. I just couldnt find any certain alternative possibilities. So thanks. I was concerned because it does look like many pics of of melanomas I could find online.Another question, after removing the nail for biopsy, we discovered that there were spots of discoloration on the bed below the nail too. She removed some of that for analysis too. Those werent there when last biopsied 4 years ago. Is that concerning?
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- June 10, 2016 at 11:25 pm
Thanks for the information. I figured same as you that were it a melanoma, after 6 years, younwould think there’d be more progression. I just couldnt find any certain alternative possibilities. So thanks. I was concerned because it does look like many pics of of melanomas I could find online.Another question, after removing the nail for biopsy, we discovered that there were spots of discoloration on the bed below the nail too. She removed some of that for analysis too. Those werent there when last biopsied 4 years ago. Is that concerning?
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- June 10, 2016 at 9:26 pm
I appreciate your concern. The nail would worry the heck of of me, it looks too much like the left hand side picture on this page:
http://www.dermnetnz.org/hair-nails-sweat/melanoma-nailunit.html
It is pigmented, changing, different colours, wider at the cuticle end than top end. That's enough of the worrying signs to justify the biopsy you got. I think you have done exactly the right thing here, you needed to get this biopsy.
All that said, the more likely diagnosis is this:
http://www.dermnetnz.org/hair-nails-sweat/melanonychia.html
Why don't you ring the derm who did original biopsy and get a copy of that biopsy report? Then you'll know what it was, and what it most likely is this time.
But either way, that biopsy is needed to rule out melanoma of the nail bed/matrix.
FWIW, I think if it's been six years in the making, there would be alot more destruction if it was melanoma (ulceration etc). This hasn't happened, so I'm thinking and hoping that it's the benign condition melanonychia. Either way though, the monitoring and biopsy is a smart move.
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- June 10, 2016 at 9:26 pm
I appreciate your concern. The nail would worry the heck of of me, it looks too much like the left hand side picture on this page:
http://www.dermnetnz.org/hair-nails-sweat/melanoma-nailunit.html
It is pigmented, changing, different colours, wider at the cuticle end than top end. That's enough of the worrying signs to justify the biopsy you got. I think you have done exactly the right thing here, you needed to get this biopsy.
All that said, the more likely diagnosis is this:
http://www.dermnetnz.org/hair-nails-sweat/melanonychia.html
Why don't you ring the derm who did original biopsy and get a copy of that biopsy report? Then you'll know what it was, and what it most likely is this time.
But either way, that biopsy is needed to rule out melanoma of the nail bed/matrix.
FWIW, I think if it's been six years in the making, there would be alot more destruction if it was melanoma (ulceration etc). This hasn't happened, so I'm thinking and hoping that it's the benign condition melanonychia. Either way though, the monitoring and biopsy is a smart move.
Tagged: acral, cutaneous melanoma
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