Black Toenail From Skin Cancer
Your alarm bells should ring if the discoloration extends beyond the nail itself. If you can rule out other causes such as shoes that are too small or a falling object and your nail and its surroundings are slowly changing color, you should have it checked by your doctor.
If you visit the pedicure regularly and you are an avid nail polish user, carefully check your toes between nail polish changes. That way you can identify any changes. It would be best if everyone has a skin check done every year by the doctor or dermatologist.
You can do this and this is how you can prevent it: This form of melanoma is extremely rare and, like other forms of skin cancer, can be fatal. If detected early, it is easily treatable. Surgery is the only treatment option for subungual melanoma, where the surgeon removes your entire nail. Since the subungual melanoma is not caused by the sun, it can be more difficult to prevent it than other cancers, which can be prevented by staying out of the sun and using sunscreen with high protection if necessary. It can help to keep your feet generally clean and in good condition.
Risk Factors Of Skin Cancer
Certain risk factors are known for subungual melanoma. People with these risk factors are not immediately affected by the form of skin cancer, but they are at an increased risk. That is why they are most attentive to early symptoms. The main risk factor for subungual melanoma is long-term exposure to the harmful UV rays of sunlight and ultraviolet light (UV rays). People with dark skin, people over 50, a weakened immune system (such as from an HIV infection ) and a history of trauma to the fingers or toes are other known risk factors. Also, patients with the hereditary condition are xeroderma pigmentosum (extreme sensitivity to UV radiation with symptoms on the skin, eyes and brain ) more often affected by this type of skin cancer. Finally, having multiple birthmarks is also a potential risk factor.
Symptoms: Streak Or Stripes Under toenail Or Fingernail
Initial stage
Most patients experience symptoms on the thumb or big toe, but in principle any fingernail or toenail may be affected. Usually, a purple, brown or black stripe first appears under a toenail or fingernail. Namely, patients have the Hutchinson's mark (the stripe that extends from the nail tip to the nail bed and into the cuticle). This comes from the pigment of the melanoma cells under the nail.
Advanced stage
As cancer continues to grow, the number of stripes increases or the stripe on the nail increases. Often stripes with different colors are present, although some stripes also have no color. Besides, a nail bleeding or a lump or tumor appears under the nail. The fingernails or toenails may also come off the nail bed ( onycholysis ). The skin next to the nail takes on a darker color ( hyperpigmentation ). Furthermore, there may be a thinned, cracked or deformed nail plate. Also, the patient may have a discharge of pus from the nail and mild pain. Finally, the nail is deformed in several patients.
Without stripes
A subungual melanoma occasionally occurs without the characteristic pigmented stripes. The patient then has other signs associated with infections under the nail area, such as changes in the nail itself, nail bleeding, and pain in the nail bed.
Diagnosis Toenail Cancer
The patient initially thinks that he is suffering from a bruise or bruise and therefore does not go to the doctor with these signs as soon as possible, which delays the diagnosis of subungual melanoma. On average, the patient waits two years before visiting the doctor with the complaints. Also, some subungual melanomas are amelanotic (non-pigmented skin cancers), making early diagnosis even more difficult. The doctor examines toenail and asks questions about past injuries to the toenail. The doctor also wants to know when the nail changes have started, which nail changes have occurred and so on.
Diagnostic Research
The doctor takes a biopsy of the nail matrix (nail root) as well as the nail bed. A pathologist examines the nail cells microscopically to determine if there is cancer. The melanoma cells have a typical appearance. If the doctor is aware of the diagnosis of melanoma, he will order further tests to determine the cancer stage. Subungual melanoma is sometimes still in situ; the cells are then a precursor to cancer but are not yet fully developed as cancer cells. The most serious form of subungual melanoma is stage IV. The cancer cells have spread to other organs at this stage.
Differential Diagnosis
The doctor may mistake a subungual melanoma for a subungual hematoma. A subungual hematoma is a medical term for bleeding under the nail. After an injury, a crack occurs in the blood vessels under the nails, causing bleeding. With a subungual hematoma, a healthy nail eventually grows again. The discoloration pattern with a subungual hematoma is also more irregular (urination, drops) than with a subungual melanoma, because in the form of skin cancer a visible band (stripe) is formed on the nail.
Some conditions that may resemble subungual melanoma include:
- deposits of melanin under the nail that occur as a result of pregnancy, as well as from chemotherapy or radiotherapy
- a blood blister
- a lack of calcium (hypocalcemia)
- an ordinary hereditary characteristic
- a birthmark
- a squamous cell carcinoma (a form of skin cancer)
- onychomycosis ( fungal nail )
- paronychia (infection of the nail bed)
- pyogenic granuloma (growth of nail tissue)
Treatment Through Surgery
The doctor performs an operation in which he surgically removes the affected area. This requires him to surgically remove the entire fingernail or sometimes part of the finger or toe ( amputation ). If cancer has spread to the lymph nodes (lymph node metastases) or metastases ( metastases ) are present throughout the body, palliative radiotherapy is often the only treatment option to reduce pain. However, it is no longer possible to cure cancer with metastases throughout the body. Other patients usually receive chemotherapy after surgery and sometimes also radiotherapy.
Prognosis Of Subungual Melanoma
The outlook for a subungual melanoma is worse than for other types of melanomas, as the diagnosis is often delayed. Five-year survival for a subungual melanoma varies between 16 to 87%, depending on the cancer stage. Early diagnosis of skin cancer improves treatment success rates and survival rates. The prognosis is often related to the depth of the tumor in the skin. The deeper a tumor is in the skin, the more deadly a subungual melanoma usually is.
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