When most people think of melanoma, they think of skin cancer caused by sun exposure. However, melanoma can also develop under the toenail or fingernail, a condition known as subungual melanoma. Though rare, it is a serious form of cancer that requires early detection and treatment for the best outcomes.
At North Shore Foot & Ankle, our board-certified podiatrists are experienced in diagnosing and treating nail and skin conditions of the foot, including subungual melanoma. Awareness and education are key to catching this condition early.
What Is Subungual Melanoma?
Subungual melanoma is a type of melanoma that originates in the nail matrix (the tissue beneath the nail). It most commonly affects the big toe but can occur in any toenail or fingernail. Unlike many other forms of melanoma, it is not strongly linked to sun exposure.
This type of melanoma is often mistaken for bruising or fungal infection, which can delay diagnosis. Because of this, podiatrists play an important role in evaluating nail changes and spotting signs of potential cancer.
Signs and Symptoms of Subungual Melanoma
- A dark streak or band that runs the length of the nail (brown, black, or bluish in color).
- Pigment that extends into the skin around the nail (Hutchinson’s sign).
- Nail splitting, cracking, or lifting without injury.
- Persistent changes in the nail that do not grow out or resolve over time.
- Pain, bleeding, or nail deformity in advanced stages.
If you notice a dark band under your nail that does not improve, it’s important to have it evaluated by a foot and ankle specialist.
Diagnosis and Treatment
Because subungual melanoma can mimic other conditions, diagnosis typically involves:
- A clinical exam of the nail and surrounding tissue.
- A biopsy to confirm whether cancer cells are present.
- Imaging or additional testing if the melanoma has spread.
Treatment may involve:
- Surgical removal of the affected portion of the nail or nail bed.
- Wide excision or amputation in more advanced cases.
- Referral to an oncologist for additional cancer care if necessary.
Early diagnosis is critical—patients who begin treatment promptly have a significantly better prognosis.
Q&A: Subungual Melanoma
Q: Is subungual melanoma common?
A: No, it is a rare condition, but because it can be deadly if missed, podiatrists are vigilant about ruling it out when patients present with nail changes.
Q: How do I know if a nail streak is melanoma or just a bruise?
A: A bruise will typically grow out with the nail over several weeks. If the streak stays in the same place, widens, or darkens, it may be a warning sign of melanoma.
Q: Who is most at risk?
A: While anyone can develop subungual melanoma, it is more common in people over 50 and in individuals with darker skin tones. Unlike typical melanoma, it does not have a strong correlation with UV exposure.
Q: Can toenail fungus be confused with subungual melanoma?
A: Yes, fungal infections can cause nail discoloration and thickening. However, melanoma does not respond to antifungal treatments. If your nail does not improve, further testing is necessary.
Q: When should I see a podiatrist?
A: If you notice any persistent discoloration, nail changes, or pain without an injury, you should schedule an appointment right away. Early evaluation can save your life.
Contact North Shore Foot & Ankle
If you have noticed unusual changes in your toenails or are concerned about subungual melanoma, our team is here to help. With multiple convenient locations, expert care is always close by.
Website: northshorefootandankle.com
- Lynbrook Podiatry Office
50 Hempstead Ave, Ste B, Lynbrook, NY 11563
Phone: (516) 599-0302 - Syosset Podiatry Office
175 Jericho Turnpike, Suite 300, Syosset, NY 11791
Phone: (516) 496-7676 - Flushing Podiatry Office
72-03 164 St., Flushing, NY 11365
Phone: (718) 591-3320 - Rosedale Podiatry Office
140-04 248 St, Rosedale, NY 11422
Phone: (718) 949-4844 - Plainview Podiatry Office
1144 Old Country Rd, Plainview, NY 11803
Phone: (516) 942-0620
Your health is too important to ignore—if you see something unusual in your toenails, let us evaluate it promptly.
