Melanonychia images: what to look for

Melanonychia often appears as a brown or black band running from the nail base toward the tip. Images may show whether a band looks narrow or broad, regular or irregular, and whether pigment seems to involve the surrounding skin. Camera exposure and shadows can change apparent colour, while polish or staining can hide the nail surface.

A photograph cannot show how the mark feels, whether it is changing, or what is happening beneath the nail. A clinician may use magnification and compare the nail with the person’s other nails. If the pattern raises concern, a tissue sample may be needed for a diagnosis.

Take a focused photograph with the whole nail visible, then a closer image without polish. Use even daylight, keep the camera parallel to the nail and include a second view showing the cuticle and nearby skin. Repeat photographs under similar conditions so changes in width or colour are easier to judge.

Bring the images to an appointment and describe when the band began, any injury or nail biting, and whether other nails changed. Avoid using an online image match as reassurance or as a diagnosis. A nail examination is more useful than comparing a single picture with examples online.

Arrange prompt dermatology review for a new band that widens, has several shades, loses its straight borders, or reaches the skin around the nail. Seek earlier help when the nail is painful, bleeding, lifting, swollen or rapidly changing.

Ask what features in your nail are reassuring or concerning, whether serial photographs are suitable, and when you should return. If a biopsy is suggested, ask how the sample will be taken and what healing changes to expect.