Topic

Fingernail Melanoma

Just recently I have notice that I have longitudinal dark lines on my left thumb and pointer finger as well as on my right thumb and ring finger. I an a 53 year old African American male. Thus far all research that I have read leave me paralyzed with fear. Prognosis appears extremely poor. Please share possible difrential diagnosis. Please!

2014-12-11 11:07:12

David

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Hello Thanks for posting your query. I can understand your concern for a melanoma for these longitudinal dark lines on the nails of four fingers. But before labeling it as melanoma we have to rule out other possibilities. First of them is splinter hemorrhages which are longitudinal thin lines red or brown in color that occur beneath the nail plate. They are visible when capillaries within the epidermal ridges leak. They are found in local trauma psoriasis or localized fungal infection or endocarditis. Splinter hemorrhages are thought to be a more specific indicator of endocarditis if they are present proximally rather than distally on the nail plate. So considering your age endocarditis also should be ruled out which is an inflammation of the inner layer of the heart the endocardium. You should consult a physician and get it ruled out by getting a physical examination ECG or an ECHO done. Secondly it can be due to melanonychia which is a brown or black pigmentation of the nail plate caused by the presence of melanin commonly appearing as a longitudinal band on the nail plate. It can be due to four main causes which are simple melanocytic activation; increased activation (with a normal number) of melanocytes; benign melanocyte proliferations (lentigo nevus); and malignant melanocyte proliferation (melanoma). While the first three are benign fourth one which is melanoma is malignant. Now to rule out melanoma you need to get it examined from a dermatologist and get a physical examination done. In subungual melanoma it usually presents as a wide (>3mm) new or changing pigment band in a single nail. Dermoscopic examination may reveal more details showing pigmented lines of varying colour width and spacing and this examination can be done by a dermatologist. If melanoma is suspected then he may take biopsy samples and send the nail sample for histopathological examination. Hope that this information helps and hope that you get better soon. Wishing you good health.

2014-12-11 11:08:10

Ben