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You may not pay much attention to the appearance of your nails. Even if you regularly treat yourself to mani-pedis, you may miss out on symptoms of a deadly health threat, one that may lurk right beneath the polish.
That menace may be a tumor. Found right under nail plates, these lesions can develop on your fingers and toes. And, while they don’t get the kind of notoriety other bodily tumors do, they too can be benign or cancerous—malignant with any of several types of cancer, in fact. As such, these tumors can vary in appearance and size.
So how might you know if you have a nail tumor? Here’s everything you need to know.
Look for these signs
Discolorations on or under the nail can be a red flag. Often, they’re considered normal and go ignored—but they shouldn’t be. The most serious nail tumor, melanoma, may look like a brown, black, or grey line or streak on or underneath the nail. The nail may split or appear flaky and scaly. The texture of the nail might be thin, uneven, or ridged. Bumps may form under or around the nail. When multiple nails are involved, the condition is less likely to be cancerous.
“Skin cancer may appear as a brown or black streak that runs the length of the nail," says Dr. Brian Morrison, a dermatologist with Sylvester Comprehensive Cancer Center. “Many of my patients of color are surprised to learn that.” In fact, people with darker skin are particularly vulnerable to nail tumors' risks for this very reason.
And while this might sound like an aesthetic concern, metastasis of a cancerous tumor can be fatal. "This is what killed Bob Marley,” Morrison says. “He had a subungual [beneath the nail plate] melanoma on his toe."
"While persons of color aren’t necessarily more likely to get nail tumors, they are less likely to seek out routine dermatological care for skin cancer screenings, including the evaluation of all 20 nails," Morrison says.
Some nail tumors are cancerous; others are just unsightly and irritating
Malignant (cancerous) and benign (non-cancerous) growths can look similar in appearance. For an accurate diagnosis and treatment, a dermatological exam and, potentially, a biopsy are needed.
Morrison, along with Sylvester's team of dermatological oncologists, treat malignant nail tumors, such as:
- squamous cell carcinoma (or Bowen's disease)
- onychocytic carcinoma
Common benign nail tumors include:
- nevus (moles)
- glomus tumor
Common questions answered
Are these tumors contagious to others?
No. But squamous cell carcinoma of the nail has been linked with Human Papilloma Virus (HPV), which is infectious and can cause warts. "It is possible that getting the HPV vaccine could help protect against this type of cancerous tumor," says Morrison. "More research will need to be done in this area to confirm any true benefit."
What is the treatment for malignant nail tumors?
"The recommended treatment is surgical excision of the lesion," Morrison says. "Non-malignant tumors do not always require surgical removal unless they’re painful or otherwise symptomatic."
What are the possible treatment outcomes?
"The outcome for patients depends on where the tumor is and how aggressively it's treated," Morrison says. "Excision of the complete nail matrix [the cells that make up the hard part of the nail] may result in permanent nail dystrophy, like a split nail. When a tumor involves only the distal matrix—the cells that make up the underside of the nail—a biopsy or surgery is less likely to cause visible damage, since it's hidden beneath the remaining nail plate."
Everyone, and especially those with dark skin, should be mindful of changes in the appearance or texture of their nail beds. If you see something suspicious, don't ignore it or assume it will resolve on its own. See a dermatologist for an exam and an appropriate course of treatment.
See a cancer expert today, in-person or virtually. For more information, visit InPursuitOfYourCure.com, or call 844-324-HOPE (4673).