What should you know about subungual melanoma?

A brown or black band may widen, develop uneven colour, or become less regular over time. Pigment can extend onto the skin beside the nail, and the nail may split, lift, or develop a lump. Bruising and harmless pigment changes can look similar, so a dark mark is not by itself a diagnosis. An examination of the nail unit and the rest of the skin helps guide the next step.

Diagnosis usually requires a biopsy of the suspicious area. If melanoma is confirmed, the report helps the care team plan treatment and decide whether further staging tests are useful. The main treatment is removal of the affected tissue with an appropriate margin; additional treatment depends on the findings.

Arrange a dermatology appointment for a new or changing pigmented nail mark, especially when it affects one nail without a remembered injury. Photographing the nail in consistent lighting can help show change, but it does not replace examination. Do not cover a changing mark with cosmetic nail products before an appointment. Treatment may include Skin Cancer Surgery or Surgical Excision, with specialist planning for deeper or wider disease.

Seek prompt review if pigment widens, becomes irregular, reaches the surrounding skin, or is joined by bleeding, pain, a persistent open area, or nail destruction. Urgent medical attention is appropriate for severe swelling, spreading redness, or fever after any nail injury or procedure. The urgency comes from the change itself and the need for diagnosis, not from assuming that every dark nail is melanoma.

Ask whether a nail-unit biopsy is needed, what the sample will include, and how the result will guide treatment. If melanoma is confirmed, ask whether Sentinel Lymph Node Biopsy, Tumour Removal Surgery, Immunotherapy, or structured Follow-Up After Cancer Treatment is relevant to your findings.