What should you know about subungual melanoma dermoscopy?

A dermatoscope provides magnified, illuminated views of the nail plate, nail bed, and surrounding skin. It may help a clinician assess whether pigment is regular or uneven, whether bands run in a consistent direction, and whether pigment extends onto the nearby skin. These patterns help decide whether the change can be monitored or needs sampling.

Dermoscopy is an assessment tool, not a cancer test that gives certainty on its own. A bruise, benign pigment, infection, and melanoma may overlap in appearance. The clinician also considers how long the mark has been present, whether it is changing, and whether one or several nails are involved.

During the appointment, the nail is examined with and sometimes without contact from the device. The clinician may compare other nails and document images for future review. If the pattern remains concerning, a biopsy or Mole Removal procedure may be discussed; the precise approach depends on the location of the pigment and the nail structures involved. Avoid applying opaque polish before assessment.

Arrange review for a new, widening, or unevenly coloured band, pigment that reaches the skin beside the nail, or nail splitting without a clear cause. Seek prompt care if the area bleeds, becomes painful, ulcerates, or changes quickly. Do not wait for dermoscopy to become available if there is an infected-looking wound with spreading redness, drainage, or fever.

Ask what features were seen through the dermatoscope, whether comparison images are useful, and what change would trigger a biopsy. Ask how a sample could affect the nail and how long healing and result discussions may take.