Dark Brown Nail Streak Leads to Rare Melanoma Diagnosis
- A 40-year-old woman from England was shocked to learn that the brown streak on her fingernail was a rare form of melanoma. She was even more stunned when the diagnosis led to her finger's amputation.
- When it comes to examining yourself for skin cancer, it's natural (and obvious) to check your skin and moles. But check your finger and toenails for signs of skin cancer, too.
- While some fingernails streaks may be a sign of one specific type of melanoma (subungual melanoma, the type Elizabeth Misselbrook was diagnosed with), fingernails aren’t an indicator of overall skin health.
"I was upset when they said they had to amputate," Elizabeth Misselbrook told the Daily Mail, "but I was really worried … so I kind of wanted them to make sure it (the melanoma) didn't come back."
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Elizabeth's fingernail grew back later that year, and when it did, she noticed another line. But this time, the line was "much darker and wider," she told the Daily Mail.
She went back to her doctor for yet another biopsy; this time, Elizabeth got her answer. In May 2021, she was diagnosed with early-stage subungual melanoma. Since the cancer had already occurred twice on the same finger, she was advised to remove the finger completely.
And while Elizabeth needed the finger to play the flute, she agreed to the amputation for fear that the cancer would occur a third time.
Since Elizabeth had two melanoma occurrences, "which had been fully removed, they wanted to make sure it didn't reoccur," she said, "so they amputated it before the first joint."
Related: Signs of Skin Cancer Can Show Up On Your Nails, But Don't Jump to Conclusions Just Yet
What to Look for When Checking Your Nails for Cancer
When it comes to examining yourself for skin cancer, it's natural (and obvious) to check your skin and moles. But check your finger and toenails for signs of skin cancer, too.
When checking your nails for melanoma skin cancer, look for the following indicators:
- Dark streak: This could look like a brown or black band in the nail, according to the American Academy of Dermatology, oftentimes on the thumb or big toe of your dominant hand or foot. But a dark streak can show up on any nail, like in Elizabeth’s case.
- Dark skin next to your nail: When the skin around your nail becomes darker, it could be a sign of advanced melanoma.
- Nail lifting from your fingers or toes: When this happens, your nail starts to separate from the nail bed; the white free edge at the top of your nail will start to look longer as the nail lifts.
- Nail splitting
- Nodule or bump under your nails: It's possible that you could also see a band of color on your nail; it could be wide and irregular, or dark and narrow.
Related: Get Your Moles Evaluated to Rule Out Melanoma
Dr. Dendy Engelman, a board-certified dermatologic surgeon and associate at Manhattan Dermatology and Cosmetic Surgery, previously told SurvivorNet it's also possible that getting your nails done at the salon could increase skin cancer risk.
"The reality is, if we have our hands or feet under these ultraviolet lamps without protection, we're exposing the dorsum of the hands or foot, the skin around the nails, to this UV light," she said. "That, over time, can increase our risk of skin cancer."
But hang on, there's a catch.
Related: Myth Busting: My Fingernails Have Streaks … Do I Have Cancer?
Nail Color Isn’t Itself an Indication of Melanoma or Other Skin Cancers
If you see one or any of these indications of skin cancer when examining your nails, don't jump to the conclusion that you have cancer. (But Dr. Engelman noted that any pigmented streaking of the fingernail should be evaluated by a doctor.)
"Subungual melanoma is a rare and often deadly type of melanoma," Dr. Engelman said. "This specific type of melanoma that occurs under the nail has fairly classic clinical findings with linear, darkly pigmented streaking of the nail and involvement of proximal nail fold or cuticle." And this is exactly what happened to Elizabeth.
However, Dr. Engelman added, nail color isn’t itself an indication of subungual melanoma, nor a reason to believe you may have other types of melanoma.
"Determining one's risk factor for melanoma solely on the color of the nail plate is neither helpful nor vetted in science," she said. "There are many causative factors that can lead to discoloration in the nail. Melanoma of the nail does not mean nor predict that you will have melanoma elsewhere on the body, either."
So, while some fingernails streaks may be a sign of this one specific type of melanoma, fingernails aren’t an indicator of overall skin health. It's important to be alert for other signs and symptoms, too, and get regular checks by your dermatologist.
Top 5 Ways to Protect Your Skin From Skin Cancer
How to Protect Your Skin
Dr. Engelman said that protecting your skin is easy with these simple steps:
- Sun avoidance during peak hours: This means from 10 a.m. to 2 p.m. It doesn't mean you should never go outside during the middle of the day, but make sure you're protected when you go outdoors.
- Cover your skin and eyes: Wearing a wide brim hat or sunglasses will protect your face, the top of your head, your ears and the delicate skin around your eyes.
- Wear an SPF of 30 or higher: Plenty of facial moisturizers have SPF built into them. Dr. Engelman recommends reapplying every few hours, or after excessive sweating or swimming.
- Get an annual skin check: If you happen to notice anything out of the ordinary in between checks (like the signs outlined in this article), schedule an appointment to talk to your doctor as soon as possible.
- No-go to tanning beds: Tanning beds can significantly increase your risk of developing melanoma. If you feel like you're just too pale, Dr. Engelman recommends a sunless tanner.
Contributing: Daisy Melamed Sanders
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