Cuticle mlanoma

[gene120]

Is it true hat if a diagnosed mole under your fingernail that does not involve cuticle means itis NOT melanoma?  Should all lines, diagnoses of a mole line in your fingernail be biopsied?

[Bhupinder Kaur, MD]

Hello,
Subungual melanoma may be suspected clinically because of a wide (>3mm) new or changing pigment band in a single nail. The diagnosis of melanoma is confirmed by biopsy of the nail matrix and nail bed. My suggestion is get it examined from a dermatologist and get it biopsied to confirm the diagnosis.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[gene120]

Thank you, I am 51, native americian, it is a brown line totally up and down straight as can be in the fingernail, it grows with the nail.  It has become more prevelent over the course of 3 years.  It also causes my nail to crack.  No hutchinson sign.  Between my knuckles under that finger has begun to have edema and pain within the last month and a half.  No family history.  I saw a dermatologist, he said he didn't want to mutilate and dark people don't get this.  He said if i've lived 3 years I probably will live.  I found the visit disturbing really.  I have a second mole he left up to me to remove and he went on about the horrible scar it would leave.  I have had 2 serious sun burns where it blistered and peeled.  I am very sensative to the sun.  I have had 4 reoccurances of thyroid cancer papillary and follicular due to a radiation exposure while my mother was pregnant with me.  I also have had several rounds of radiation myself due to the reoccurances.  Any opinion on getting a second opinion would be most helpful

[Bhupinder Kaur, MD]

Hello,
Salient feature of subungual melanoma (melanoma under nail) is categorized according to ABCDEF. In this system A stands for age (peak incidence being in the 5th to 7th decades of life and African Americans, Asians, and native Americans in whom subungual melanoma accounts for up to one third of all melanoma cases. B stands for brown to black b and with breadth of 3 mm or more and variegated borders. C stands for change in the nail band or lack of change in the nail morphology despite, presumably, adequate treatment. D stands for the digit most commonly involved; E stands for extension of the pigment onto the proximal and/or lateral nailfold (ie, Hutchinson's sign); and F stands for family or personal history of dysplastic nevus or melanoma.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.