Dark spot under my toe nail

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1/2/2013 4:51pm
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Replies: 8

It is near the center and it seems too small to be an injury. (It is less about 1/8")

My doctor is sending me to a specialist for diagnosis. How concerned should I be? Is there any way to tell by looking? Can anyone here offer insight or suggestion?

If they do a biopsy won't that spread cells that might be really bad to spread??

I am very concerned as there is cancer in my family.

 

Thanks,

David

 

 

Linny - (1/2/2013 - 9:00pm)

It's good that your doctor is sending you to a specialist to rule out any problems.

Melanomas under your nails are bar-shaped and not circular. They also don't grow out with the nail. One of the things the specialist may do is mark the top and bottom of the spot by scraping your nail. They do this to get a measurement and to see if if grows out with the marks they made on your nail. Then you go home and wait about 6 weeks because that's the amount of time it will take for them to see if the spot stays within the scratches as they grow out with the nail. If the spot grows out, it's not a melanoma. If the spot stays put, then more invasive measures will be taken.

Stage III, Unknown Primary; 1 positive node in left axilla; currently participating in GSK DERMA (MAGE A3 vaccine) trial

Thank you very much for the info.

My spot seems to roughly follow the radial nail lines on the "top" and "bottom". It is just under 1/8" from edge to edge (measured along the direction the nail grows).

One "side" is clearly defined as a line. The other side is less defined and gradiually less dark, so it is harder to give one dimension for this axis, but it is slightly wider than the first one.

So, it is more like a square than a "bar", but if it grew in one direction it would become a bar.

 

 

Thank you very much for the info.

My spot seems to roughly follow the radial nail lines on the "top" and "bottom". It is just under 1/8" from edge to edge (measured along the direction the nail grows).

One "side" is clearly defined as a line. The other side is less defined and gradiually less dark, so it is harder to give one dimension for this axis, but it is slightly wider than the first one.

So, it is more like a square than a "bar", but if it grew in one direction it would become a bar.

 

Anonymous - (10/27/2013 - 9:37am)

hi! can i ask if this is melanoma , i hope youll give me a reply and an email to let me send a photo pls :(

Odds are that it is nothing to worry about (Yea, easier said than to not worry any!) 

       As to spreading by a biopsy, they could do a needle biopsy which would not spread it.  If they do a surgical biopsy (much more definitive) they may remove either a portion of or the full toenail.  They should remove the entire spot.  If it were to be found to be melanoma they would go in for wider margins to reduce the chances of there being missed cells.  The sentiinal node should be located prior to or concurrently with a wider excession.

    Melanoma under the nails is normally acral lentigimous melanoma.  If found late (usually found late) then it can be very serious.  Learn what it is as early as possible and you have the best chance of overcoming a bad diagnosis.

   If it were to be diagnosed as a melanoma, then the tumor tissue should be tested to determine which type of DNA mutation it would contain, C-kit, BRAF, etc.  The type mutation determines future treatment if later there is further spread. 

   Please let us know what you learn.

I'm me, not a statistic. Praying to not be one for years yet.

JTiernan - (1/4/2013 - 10:02pm)

I would not do a needle biopsy. With my melanomas they have always told me that when they pull the needle out it has a good possibility of spreading it. I have a mass in my knee right now which I am having surgically removed at Sylvestor. They did not want to do a needle biopsy due to the risks.
Please be careful....
Best,
Jean

Jean Tiernan

Here are two url's that refer to toenail problems.  They do underplay the seriousness of melanoma being malignant and they indicate that radiation and/or standard chemo are cures.  I responded to one.

How-to-Tell-If-You-Have-a-Toenail-Melanoma&id=1492899

://www.nailfungusbliss.com/nail-fungus/how-to-identify-a-toenail-melanoma/c...

   MY Response to this one:

  1. JerryfromFauq on January 5th, 2013 at 10:35 pm Your comment is awaiting moderation.

    Mucosal melanoma and Acral lentiginous melanoma are not the same melanoma. Any melanoma is considered malignant and can be deadly if not treated in the early stage. I am a c-kit stage IV melanoma patient. Surgery is the best treatment. Radiation therapy may reduce the tumor load but seldom is an actual cure for melanoma. Most Chemotherapy treatments have less than a 1% long term success rate at stopping melanoma progression. Newer targeted chemo (many in clinical trials) are most likely to be successful if one of the immunotherapy treatments (5% success rate and a 15% partial response rate are not successful.)

 

On the subject of Spreading of Melanoma by needle aspirations/surgery.   I had not researched this in detail, but have learned that there is debate between specialists as to which is the most likely to cause the most spread.  Of course if it is not melanoma the FNA cannot cause spresd.If the aspiration gives anything beside an unqualified clear, I would want immediate surgery.  I had two fine needle aspirations (FNA's)in different locations that were inconclusive (2006 & 2007).  I had immediate surgery - both were melanoma.  In the case of a nail FNA, if any melanoma were suspected from the FNA, I would expect that all tissue the needle went through would be removed in the margins for the surgery.

I'm me, not a statistic. Praying to not be one for years yet.

Program doesn'ts like me giving the URL.   Can I break it up in a way one can find the article?

Try a Google search for :

How-to-Tell-If-You-Have-a-Toenail-Melanoma

 

Also look at pictures on Dermnet.com/images/nail-melanoma

I'm me, not a statistic. Praying to not be one for years yet.