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subungual melanoma thumb nail

Forums General Melanoma Community subungual melanoma thumb nail

  • Post
    bluevit
    Participant

      Hello,

      I have a biopsy scheduled in 2 days of my thumb nail.

      Is there anyone that has experience with subungual melanoma, or Acral Lentiginous Melanoma?

      Please see this picture of my thumb.

      http://nz.skyflux.com/IMG_2416.JPG

      This is after watching it grow out from the cuticle for 2 weeks.

      What kind if biopsy will I get? (punch biopsy?) and where exactly is the best place for them to take it? What kind of accuracy should I expect from the biopsy?

      I am scared and trying to get a diagnosis asap because I have had other rare health problems over the past year that a heap of blood tests was unable to figure out other than probable psoriasis and food allergies. I was 99% back to normal curing myself through a healthy diet, but now this!!! As you can see my thumb nails used to grow out split back when my skin was leaking lymphocytes and falling off all over my body. All my other finger and toe nails are growing out perfect now except this one.

      Thank You

    Viewing 8 reply threads
    • Replies
        Janner
        Participant

          Typically, they would not do a biopsy now.  It could easily be trauma related.  In general, melanoma under the nails tends to occur in darker skinned people.  Not a hard and fast rule, but most common.  Normally, you would watch the lesion to see if it grows out with the nail.  If it grows with the nail, it is most likely blood/trauma related.  If it stays put, then that is when it might be evaluated for fungus or something more sinister.  In addition, that type often appears as streaks.  I'd guess this isn't melanoma but you can't tell for certain without a biopsy.

          As for the biopsy type, most likely a punch.  Not sure if they will have to remove the nail or not.  As for accuracy, it is either melanoma or it isn't.  Not sure what you're really asking there.  As long as you have a dermatopathologist reading the slides, I think you can safely go with their diagnosis.

          My personal thoughts are if you have only had this two weeks, and it appears to be growing out with the nail, and you skin is quite pale, this is most likely not melanoma.  You might be jumping the gun thinking this is anything melanoma related.  But it never hurts to have a dermatologist evaluate it.

          Best wishes,

          Janner

          Janner
          Participant

            Typically, they would not do a biopsy now.  It could easily be trauma related.  In general, melanoma under the nails tends to occur in darker skinned people.  Not a hard and fast rule, but most common.  Normally, you would watch the lesion to see if it grows out with the nail.  If it grows with the nail, it is most likely blood/trauma related.  If it stays put, then that is when it might be evaluated for fungus or something more sinister.  In addition, that type often appears as streaks.  I'd guess this isn't melanoma but you can't tell for certain without a biopsy.

            As for the biopsy type, most likely a punch.  Not sure if they will have to remove the nail or not.  As for accuracy, it is either melanoma or it isn't.  Not sure what you're really asking there.  As long as you have a dermatopathologist reading the slides, I think you can safely go with their diagnosis.

            My personal thoughts are if you have only had this two weeks, and it appears to be growing out with the nail, and you skin is quite pale, this is most likely not melanoma.  You might be jumping the gun thinking this is anything melanoma related.  But it never hurts to have a dermatologist evaluate it.

            Best wishes,

            Janner

              bluevit
              Participant

                Thank you for the responses.

                After over 2 weeks it is starting to feel faintly sore and a slight bump hardness under the skin just back from the cuticle. It feels like it is getting bigger back that direction as well.

                I do not remember at all doing anything to my thumb that would have hurt it. I am especially careful these days due to psoriasis stuff I overcame last year that is still showing up on some fingers.

                bluevit
                Participant

                  Thank you for the responses.

                  After over 2 weeks it is starting to feel faintly sore and a slight bump hardness under the skin just back from the cuticle. It feels like it is getting bigger back that direction as well.

                  I do not remember at all doing anything to my thumb that would have hurt it. I am especially careful these days due to psoriasis stuff I overcame last year that is still showing up on some fingers.

                  Janner
                  Participant

                    I'd still say trauma or some other benign thing – not melanoma.  Melanoma typically doesn't cause pain.  This seems much more likely blood/blood blister/trauma related.  Just because you don't remember hurting it doesn't mean it isn't some benign issue.  False negatives?  Again, as long as a good dermatopathologist reads a biopsy, I think you can expect a pretty decisive diagnosis. 

                    Janner
                    Participant

                      I'd still say trauma or some other benign thing – not melanoma.  Melanoma typically doesn't cause pain.  This seems much more likely blood/blood blister/trauma related.  Just because you don't remember hurting it doesn't mean it isn't some benign issue.  False negatives?  Again, as long as a good dermatopathologist reads a biopsy, I think you can expect a pretty decisive diagnosis. 

                      Janner
                      Participant

                        I'd still say trauma or some other benign thing – not melanoma.  Melanoma typically doesn't cause pain.  This seems much more likely blood/blood blister/trauma related.  Just because you don't remember hurting it doesn't mean it isn't some benign issue.  False negatives?  Again, as long as a good dermatopathologist reads a biopsy, I think you can expect a pretty decisive diagnosis. 

                        bluevit
                        Participant

                          Thank you for the responses.

                          After over 2 weeks it is starting to feel faintly sore and a slight bump hardness under the skin just back from the cuticle. It feels like it is getting bigger back that direction as well.

                          I do not remember at all doing anything to my thumb that would have hurt it. I am especially careful these days due to psoriasis stuff I overcame last year that is still showing up on some fingers.

                        Janner
                        Participant

                          Typically, they would not do a biopsy now.  It could easily be trauma related.  In general, melanoma under the nails tends to occur in darker skinned people.  Not a hard and fast rule, but most common.  Normally, you would watch the lesion to see if it grows out with the nail.  If it grows with the nail, it is most likely blood/trauma related.  If it stays put, then that is when it might be evaluated for fungus or something more sinister.  In addition, that type often appears as streaks.  I'd guess this isn't melanoma but you can't tell for certain without a biopsy.

                          As for the biopsy type, most likely a punch.  Not sure if they will have to remove the nail or not.  As for accuracy, it is either melanoma or it isn't.  Not sure what you're really asking there.  As long as you have a dermatopathologist reading the slides, I think you can safely go with their diagnosis.

                          My personal thoughts are if you have only had this two weeks, and it appears to be growing out with the nail, and you skin is quite pale, this is most likely not melanoma.  You might be jumping the gun thinking this is anything melanoma related.  But it never hurts to have a dermatologist evaluate it.

                          Best wishes,

                          Janner

                          MichaelFL
                          Participant

                            The fact that there seems to be some brusing in the lower lwft corner may suggest a blood blister or some type of trauma instead. And you also say it is moving with the nail. Melanoma will stay in the same place.

                             

                            Only a biopsy will tell for sure, but I would guess this is trauma to your nail/finger and it has bled slightly.

                            MichaelFL
                            Participant

                              The fact that there seems to be some brusing in the lower lwft corner may suggest a blood blister or some type of trauma instead. And you also say it is moving with the nail. Melanoma will stay in the same place.

                               

                              Only a biopsy will tell for sure, but I would guess this is trauma to your nail/finger and it has bled slightly.

                              MichaelFL
                              Participant

                                The fact that there seems to be some brusing in the lower lwft corner may suggest a blood blister or some type of trauma instead. And you also say it is moving with the nail. Melanoma will stay in the same place.

                                 

                                Only a biopsy will tell for sure, but I would guess this is trauma to your nail/finger and it has bled slightly.

                                bluevit
                                Participant

                                  what I mean by accuracy is the chance of false negatives.

                                  bluevit
                                  Participant

                                    what I mean by accuracy is the chance of false negatives.

                                      Pamelarun
                                      Participant

                                        I have a similar dark spot under my nail. Derm suggested matrix biopsy. Was yours melanoma?

                                         

                                        bluevit
                                        Participant

                                          My results came back benign (aka nothing).

                                          I am glad I had it done though because it was scary at the time, and all the other health stuff I went through. I think it was about 6 months later to my surprise my entire nail had grown out perfectly normal despite that huge hole they put in it. I took extremely good care of it though. Left it banadged for days at a time. The nerves in my thumb hurt on and off for months but I think they are slowly back to normal too. I can still feel the pain if I think about it. I also still have a very very tiny dark line that grows out along the side of where it was. I guess once again, we have no true answers. Another medical mystery that someday doctors might actually figure out and have a real answer for us.

                                           

                                          All the best!

                                          bluevit
                                          Participant

                                            My results came back benign (aka nothing).

                                            I am glad I had it done though because it was scary at the time, and all the other health stuff I went through. I think it was about 6 months later to my surprise my entire nail had grown out perfectly normal despite that huge hole they put in it. I took extremely good care of it though. Left it banadged for days at a time. The nerves in my thumb hurt on and off for months but I think they are slowly back to normal too. I can still feel the pain if I think about it. I also still have a very very tiny dark line that grows out along the side of where it was. I guess once again, we have no true answers. Another medical mystery that someday doctors might actually figure out and have a real answer for us.

                                             

                                            All the best!

                                            bluevit
                                            Participant

                                              My results came back benign (aka nothing).

                                              I am glad I had it done though because it was scary at the time, and all the other health stuff I went through. I think it was about 6 months later to my surprise my entire nail had grown out perfectly normal despite that huge hole they put in it. I took extremely good care of it though. Left it banadged for days at a time. The nerves in my thumb hurt on and off for months but I think they are slowly back to normal too. I can still feel the pain if I think about it. I also still have a very very tiny dark line that grows out along the side of where it was. I guess once again, we have no true answers. Another medical mystery that someday doctors might actually figure out and have a real answer for us.

                                               

                                              All the best!

                                              Pamelarun
                                              Participant

                                                I have a similar dark spot under my nail. Derm suggested matrix biopsy. Was yours melanoma?

                                                 

                                                Pamelarun
                                                Participant

                                                  I have a similar dark spot under my nail. Derm suggested matrix biopsy. Was yours melanoma?

                                                   

                                                bluevit
                                                Participant

                                                  what I mean by accuracy is the chance of false negatives.

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