A podiatrist’s guide to catching this quiet threat
As a podiatrist, I spend my knees deep (or toes should I say) from my toenails to Verca. But often I see something much more ominous. What could be literally a matter of life and death: nail melanoma. challenge? Many people don’t know how to find nail melanoma, making early detection difficult and increasing the risk of a slow diagnosis.
Now I know what you’re thinking. “Melanoma? Inside the nail?” Yes, it happens. It was something famous musician Bob Marley suffered and led to his unfortunate pass. And the tricky part? It’s surprisingly easy to miss. That’s why you need to know whether you’re a fellow podiatrist, a nail technician, someone who loves a good pedicure, and what to look at.
So let’s get into it. What does nail melanoma look like and when should the client or patient be sent directly to the dermatologist?
What exactly is nail melanoma? How can I find it?
Nail melanoma (or, if we are flashy, sub-sized mernoma) is a rare but aggressive skin cancer that forms underneath the nails. It often starts with a nail matrix (the hidden part below the cuticle) and becomes difficult to detect at the early stages.
Unlike the more common superficial diffusive melanomas that may be found on sunlight exposed skin, nail melanomas do not require sunlight to flourish. It’s mean, it grows slowly and is often ignored until it’s too late.
How to Find Nail Melanoma: Subtle Signs You May Miss You
This is where things are difficult. Nail melanomas are also spoofed as bruises, fungal infections, or just natural changes in pigmentation, even in people with dark skin colours where nail pigmentation is more common. However, it is important to remember: do not try to self-diagnose nail melanoma. If you notice any of these changes and are unclear, ask for a medical evaluation rather than assuming it is harmless. Early professional evaluations can save lives. Important signs to watch out for:
1. Dark stripes that do not grow
Dark brown or black stripes that run vertically through the nails are the most common signs. But here’s the catch. It does not move up or grow as does the nails. If that “breast” doesn’t exist a few months later, it’s time to investigate.
2. Pigments that stretch on the skin (Hatchinson’s signature)
If pigmentation is spilling on the cuticle or surrounding skin (called the Hutchinson sign), consider it a red flag. This is a classic sign of melanoma creeping up beyond the nail plate.
3. New or Changing Nail Streaks
If someone had a faint nail stripe that remains the same for years, it is probably benign. However, if a new streak appears, it becomes wider, darker, or changes shape, the alarm bell should start ringing.
4. Dystrophy or destruction of nails
Melanomas do not always stay properly under the nail. You can distort, split, or destroy the nail plate. If your nails are lifting, collapsed or collapsed without obvious trauma or infection, you need to dig deeper (not literally).
5. Persistent “infection” that is not cleared
Do you think it’s fungal nails? perhaps. However, if the antifungal properties are not working and your nails are exacerbating, reconsider your diagnosis. Melanoma can mimic OneCH’s metabolic disease (fungal nails), and if you make the two wrong, it can delay life-saving treatment.
6. Pain, bleeding, or rough growth under the nail
Melanomas are not necessarily in neat striped packages. It can be present as a mass, ulcer, or spontaneous bleeding under the nail. When a client says, “I don’t remember getting injured, but the bleeding won’t stop,” Think seriously.
Who is at risk?
Melanoma does not identify, but some people do Higher risk More than others:
- People with dark skin tones (They are more likely to develop zinc addiction than individuals like skin skin).
- People with a history of trauma to their nails (Although it’s not always linked).
- Individuals with a family history of melanoma.
- People spend time in the sunless sun.
- People over 50 years old (However, it can occur at any age).
When will you refer to it? How to find nail melanoma and act quickly
If you are a practitioner or technician and have found the above warning signs, don’t hesitate. Always immediately refer to your doctor (MD) or dermatologist. Delayed diagnosis significantly increases the risk of melanoma spreading, and early referrals become critical. Even if you are uncertain, it is much better to be overly cautious than to overlook a potentially life-threatening condition.
An emergency referral should occur if:
- New or changing dark stripes appear, especially on one nail.
- Pigmentation extends to the skin (Hatchinson’s sign).
- The nails are lifted, broken, or ulcerated without a clear cause.
- There is a persistent “infection” that does not respond to treatment.
- The nail lesions are painful, bleeding, and change rapidly.
Time is the essence. Melanoma under the nail is often diagnosed late. This means there is a higher risk of spread (metastasis). Whether you’re a podiatrist or a nail technician, or simply monitoring your own health, learning to find nail melanoma early can be life-saving.
Final Thoughts: Trust your gut
If something about the nails aren’t sitting correctly with you, see it. No one will accuse you of being cautious, but missing out on melanoma can have devastating consequences.
For podiatrists and nail technology, we are often the number one line of defense. The average person hasn’t inspected their toenails with a magnifying glass, so who would do if they didn’t find them?
The next time you see stubborn nail stripes, don’t dismiss it. It can be bruises…or it could be much worse.
And in the world of melanoma, Early detection is everything.
Have you ever found a suspicious nail?
If you’ve ever encountered something serious, let’s talk about it. The more consciousness saves and shares life, the more we can reach to find these quiet threats.
Be sharp, pique your curiosity and hold those nails down!
