What should you know about dermoscopy nail melanoma?

A dermatoscope is a handheld lighted magnifier. For a nail, the clinician examines the nail plate, the skin beside it, and the skin under the nail when visible. They look at the width, colour, spacing, and direction of pigment lines, as well as whether pigment extends onto nearby skin. A changing streak, uneven pattern, or pigment involving surrounding skin may need closer assessment, but dermoscopy alone does not prove melanoma. A harmless mark, injury, infection, or other pigment condition can look unusual. The examination is generally quick and does not cut the nail.

Arrange a dermatology review for a new or changing dark streak, especially when it affects one nail, widens, becomes irregular, or does not grow out with the nail. Bring older photographs if you have them and mention trauma, nail treatments, medicines, and when the change began. The clinician may photograph the area for comparison, review it after an interval, or recommend a biopsy of the nail unit. Do not scrape, file, or cover the mark before assessment. If tissue is removed, the clinician will explain wound care and what the laboratory result means.

Seek prompt medical assessment for a rapidly changing streak, bleeding, ulceration, persistent pain, nail splitting, or pigment spreading onto the surrounding skin. An urgent appointment is also sensible if a dark mark follows no clear injury or remains in one nail while nearby nails look normal. These features do not establish cancer, but they should not be dismissed as a cosmetic issue. A dermatologist can decide how quickly the area needs examination and whether a biopsy is appropriate.

Ask what features were seen through the dermatoscope, whether the change can be photographed and monitored, and what would trigger a biopsy. Ask how a nail-unit biopsy could affect nail growth, how to protect the area afterwards, and when the result or follow-up will be available.