What should you know about melanoma fingernail?

Nail pigment can have harmless causes, including an injury or a benign pigment spot. Concern rises when one nail develops a brown or black band that becomes wider, less even, or changes shade. Pigment may extend from the nail onto the surrounding cuticle or fingertip skin. A clinician may examine the nail, skin, and nearby lymph nodes, then recommend a biopsy when the appearance cannot be explained safely by examination alone.

A biopsy is the only way to confirm melanoma. The result helps guide whether removal of the affected tissue is enough or whether further staging and treatment are appropriate.

Arrange an appointment with a dermatologist or another clinician experienced in skin and nail lesions. Do not cover a changing streak with polish before the visit. Take a clear photograph in good light and note when you first saw it, whether it followed an injury, and whether it has altered. Do not try to drain, scrape, or remove the nail mark yourself.

If melanoma is confirmed, care may include surgical excision and, depending on the findings, discussion of sentinel lymph node biopsy or other melanoma treatment. The plan is based on the lesion and examination, not on appearance alone.

Seek prompt clinical review for a new or enlarging dark band, uneven pigment, bleeding, persistent pain, nail lifting, a persistent sore, or colour spreading onto the surrounding skin. Arrange urgent help if bleeding will not stop, the finger becomes severely swollen, or pain is rapidly worsening. These signs do not prove cancer, but they should not be watched indefinitely.

Could this change be caused by trauma or another nail condition? Do you recommend a biopsy, and what part of the nail will be sampled? If melanoma is found, how will you assess its depth and whether it has spread? What follow-up checks will I need?