Melanoma is a type of cancer that forms within the melanocytes, which are the cells that produce your skin's pigment. Any area of your skin can develop melanoma, including the skin beneath your toenails. Here are four things you need to know about subungual melanoma.

What causes subungual melanoma?

The cause of subungual melanoma is still poorly understood. While melanoma that develops on other areas of your skin is linked to ultraviolet radiation (sun exposure), this isn't a likely cause of subungual melanoma. This is because it's unlikely that sunlight will pass through your toenails and damage the skin underneath.

A significant number of patients (23% to 44%) report direct trauma to the affected toenail before the onset of the melanoma, so it's possible that trauma triggers the condition. However, more research is needed to prove that trauma is really a cause and not just a coincidental finding.

What are the symptoms of subungual melanoma?

Generally, subungual melanoma develops beneath the big toe, but it can sometimes affect your other toes. Its presentation can vary quite a bit. In some cases, it presents as band-like black discoloration on the affected nail, which later spreads. The entire nail may eventually turn completely black.

In other cases, your nail bed will split or your nail will become deformed. Masses may also form beneath the nail. If you notice any changes in the appearance of your toenails, see your podiatrist.

How does it differ from other melanomas?

Subungual melanoma has a worse prognosis than other types of melanomas, according to Scientific Research Open Access. This is because it goes undetected for longer than other types of this cancer. For example, even if you're examining your skin regularly for signs of skin cancer, you may not think to check your toenails for similar problems. Even if you do check your toes, you may assume that a dark spot beneath your toenail is just a bruise or another harmless problem.

How is subungual melanoma treated?

Amputation used to be the main treatment for subungual melanoma, but fortunately, this is no longer the case. More conservative surgical methods like wide excision are currently used. Your nail will need to be removed to allow access to the melanoma underneath. The affected skin will then be removed, as well as a margin of 0.5 centimeters of healthy tissue.

Once the melanoma has been removed, reconstruction of the toenail can begin. This can be done by attaching a toenail-shaped skin graft to the wound. Since the graft is the same size and shape as a toenail, your toe will look more aesthetically pleasing than if it was just smooth and nail-less.

If you notice dark discoloration beneath your toenails, see a podiatrist right away. If you suspect that you have a problem, contact a business such as the High Desert Foot & Ankle Clinic - Wonsik Y Bollmann DPM.