Treatment Options For Subungual Melanoma

Subungual melanoma describes a form of malignancy that develops in the cells under the fingernail or toenail. When carcinogenesis takes place in cells that contain skin pigments or melanocytes, it is called melanoma. Subungual melanoma is not usually related to excessive sun exposure, unlike other types of melanoma. Subungual melanoma is not diagnosed in its early stages in most cases because the population is not very aware of this form of cancer. 

Subungual melanoma appears similar to a blood blister or a bruise that forms under the nail following an injury. However, subungual melanoma spots do not grow out with the nail the same way bruising and blood blisters would. Other indications of subungual melanoma that help distinguish it from bruising are cracking, thinning, splitting, and distortion of the nail plate. Diagnosis of subungual melanoma is made with a tissue biopsy, and there are several treatments to consider.

Local Removal Of Affected Area

An individual may need local removal of the affected area if they are diagnosed with subungual melanoma. When subungual melanoma is in its early stages, it may be able to be excised without the need to have a full amputation of the fingertip or finger. This type of surgical procedure is referred to as a wide local excision. To even take a sample of tissue from a suspected subungual melanoma lesion, the entire nail plate must be removed. 

The amount of tissue that would need to be removed beneath that point would be determined by how deep the melanoma lesion or tumor penetrates the tissues. The margins of the tumor are determined by taking scrapings of the tissue and examining them under a microscope in real-time until the surgeon reaches the layer where no cancerous or abnormal cells are seen. Once the endpoint of the subungual melanoma is determined, the surgeon removes a nominal margin of tissue surrounding the area to ensure no cancerous cells are left behind.