Subungual Melanoma Causes-Symptoms, Signs and Treatment

Subungual melanoma is a rare kind of skin cancer that develops beneath the nails. Streaks on the nails, color changes in or around the nail, a bruise under the nail that does not heal, and the nails parting from the nail bed are all symptoms.

What is Subungual Melanoma?

Subungual melanoma is a rare form of skin cancer that affects the nail unit, including the nail matrix, nail bed, and surrounding tissues. It is characterized by the malignant growth of melanocytes, the pigment-producing cells of the skin.

How to Spot and Survive Subungual Melanoma-Nail Cancer

 Causes for Subungual Melanoma

Understanding the underlying causes and risk factors of subungual melanoma is critical for successful prevention and management. While the precise reason is uncertain, the following things have been recognized as possible contributors:

  • UV Exposure: Prolonged exposure to ultraviolet (UV) radiation, whether from natural sources such as sunshine or artificial ones such as tanning beds, is a substantial risk factor for melanoma. It is critical to protect your skin from excessive UV exposure.
  • Ethnicity and age: Melanoma of the subungual regionAlthough it may afflict persons of any age, it is more frequent in elderly adults. Certain ethnic groups are more vulnerable, notably those with pale skin and a family history of melanoma.
  • Damage and Chronic Injury:  the disease has been linked to chronic damage to the nail, such as repeated pressure or injury. It is critical to take steps to avoid chronic or repetitive stress on the nails.

Symptoms and Signs – Subungual Melanoma

Early detection of the disease is critical for effective therapy. Recognizing the signs and symptoms can help with an accurate diagnosis. Keep an eye out for the following signs:

  • Pigmentation: A dark brown or black discoloration that occurs under the nail as a streak, band, or patch. It is frequently longer than the nail. From the bed to the cuticle.
  • Nail Changes: Nail thinning, splitting, lifting, or brittleness. These changes may occur in addition to pigmentation.
  • Bleeding or Ulceration: This refers to spontaneous bleeding or ulceration beneath the nail.
  • Unexplained Pain or Discomfort: Pain or discomfort in the afflicted finger or toe.
How to Spot and Survive Subungual Melanoma-Nail CancerDiagnosis and Prognosis subungual Melanoma

When subungual melanoma is detected, it is critical to get medical assistance. Correct diagnosis and staging are critical for effective treatment planning. The following stages may be included in the diagnostic process:

  • Clinical Examination: To identify the features of the pigmented lesion, a dermatologist or oncologist will visually examine the afflicted nail and surrounding tissues.
  • Dermoscopy: A non-invasive imaging procedure that provides a magnified picture of skin features. It facilitates the identification of certain melanoma characteristics. • Biopsy: During a biopsy, a tiny tissue sample from the pigmented lesion is removed for laboratory investigation. It is the only way to confirm a disease diagnosis.

This disease is staged using the TNM method, which takes into account tumor size, lymph node involvement, and the occurrence of distant metastases. Healthcare providers can use proper staging to identify the degree of the disease and make educated treatment recommendations.

 Treatment Subungual Melanoma

Effective treatment techniques for subungual melanoma are determined by a variety of criteria, including disease stage, general health, and individual preferences. The following therapeutic techniques are frequently used:

Excision Surgery

Surgical excision entails removing the tumor as well as a margin of healthy tissue. The extent of the amputation is determined by the thickness of the tumor and the depth of invasion. In severe instances of cancer, amputation of the afflicted finger may be required to accomplish full elimination.

Subungual Melanoma-Nail Cancer

Mohs Micrographic Surgery 

Mohs micrographic surgery is a specialist treatment for this. It entails precisely removing tiny layers of tissue, which are then studied under a microscope. This procedure is continued until there are no more malignant cells, resulting in little tissue loss.

Radiation Treatment

Radiation therapy destroys cancer cells and prevents their development by using high-energy X-rays or other radiation sources. It is occasionally used after surgery as an adjuvant treatment to target any leftover cancer cells or as a palliative treatment to relieve symptoms in advanced situations.


Immunotherapy makes use of the immune system of the body recognizes and destroys cancer cells. It can be given in a variety of ways, including immune checkpoint inhibitors, interleukin-2 (IL-2), or interferon-alpha (IFN-alpha). Immunotherapy has demonstrated encouraging benefits in patients with advanced or metastatic melanoma.

Personalized Medicine

Drugs or other chemicals are used in targeted treatment to target certain genetic alterations or proteins implicated in cancer development. If specific genetic abnormalities, such as BRAF mutations, are found in the disease, targeted treatment may be explored.

Self-Care, Prevention, and Prognosis Subungual Melanoma

While preventing subungual melanoma is difficult, various precautions can help minimize the risk and increase general well-being. Here are some key considerations:

  • Sun Protection: Seek shade, wear protective clothing, and use sunscreen with a high sun protection factor (SPF) to reduce UV exposure. • Regular Self-Examination: Inspect your nails regularly for any changes, such as color, bleeding, or nail irregularities. Early discovery improves prognosis greatly.
  • Avoid Trauma: Take care to avoid chronic nail trauma. Wearing suitable footwear, using protective gloves while participating in activities that may damage the fingers or toes, and keeping correct nail care are all part of this.
How to Spot and Survive Subungual Melanoma-Nail Cancer
Hematoma vs. Subungual Melanoma

Subungual melanoma is a kind of skin cancer that affects pigment-producing cells. It shows on the nail as a black band or streak and can cause abnormalities or bleeding. Examination and biopsy are used to get a diagnosis. Treatment usually consists of surgical removal and, if necessary, further treatments.

A hematoma, on the other hand, is an injury-induced accumulation of blood outside blood vessels. It looks to be a dark or reddish discoloration beneath the nail. The look and history of injuries are used to get a diagnosis. Treatment includes symptom management and, in certain situations, blood draining.

Subungual melanoma is an uncommon and dangerous disease, whereas hematoma is a frequent and typically innocuous ailment. Consult a medical expert for an accurate diagnosis and treatment.

Finally, we can say Subungual melanoma is an uncommon and possibly fatal kind of skin cancer that affects the nail unit. Individuals may take educated efforts toward optimal management of this problem by knowing the reasons, recognizing the signs and symptoms, and researching the available treatment choices. Remember to emphasize frequent self-examinations, sun protection, and consultations with medical specialists for accurate diagnosis and tailored treatment options.

NOTE: Picture and Information collected from a different source 

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