Nail melanoma: signs and treatment

Sometimes an ailment appears in the human body for no apparent reason, which is associated with uncontrolled self-reproduction of cells. One of the varieties of such ailments is nail melanoma. The initial stage of the disease is not very noticeable and may resemble other destructive processes. Therefore, patients seek help in the later stages.

Features of the disease

In simple terms, nail melanoma is a type of cancer that is characterized by aggressive development and a specific clinical picture. If we take all oncological diseases, then about 4 percent falls on this particular disease.

Medical statistics show that in most cases, the thumb on the right hand is affected. The preliminary stage of the oncological process proceeds hidden. By external parameters, it is not always possible to identify a cancerous formation.

Most often, nail melanoma is stained with epithelial pigment. In this case, it becomes much easier to establish the correct diagnosis even with a preliminary examination by a doctor. About 20 percent of malignant tumors do not have such a color, which complicates the diagnosis.

Reasons for the appearance

Various factors can lead to the degeneration of the cells of the nail plate:

• the presence on the skin of benign neoplasms such as moles, papillomas, warts and other growths that began to form a tumor body;
• congenital malformations of the epithelium with atypical influxes present on the fingers of the patient from the very beginning of life;
• the oncological process in any organs or in parts of the body that led to damage to the nail plate by metastases;
• the formation of a chancre under the nail plate, resulting from a fungal or viral infection;
• regular injuries at the site of the tumor in severe physical conditions;
• exposure to the surface of the fingers in direct sunlight.

These risk factors can give the oncological process an initial impetus. As a result, nail melanoma is formed. Photos with its development in the later stages can no longer be confused with other diseases. By the appearance of the nail plate, it immediately becomes clear that there is a cancerous formation.

The main symptoms

With cancer, attention should be paid to a number of important points. Although the disease is easily confused with a common fungal infection, there are significant signs that make it possible to establish a diagnosis.

Usually pay attention to the following symptoms of nail melanoma:

1. Tumor formation. Often a dense to the touch growth from degenerated cells is formed. It is he who begins to destroy the structure of the nail plate. Pores appear on its surface, after which the separation of layers occurs.
2. Discoloration of the nail. In fact, this is one of the most important signs of the pathological process. The surface may be painted blue, black, brown or crimson. If the surface of the nail has changed color without any noticeable damage, the patient should seek help from a medical facility.
3. The presence of a vertical strip. With the growth of the tumor body, a clear vertical line often forms, dividing the surface into two parts. It most often appears in the center of the plate. The strip may change color over time. Everything will depend on the specific course of the oncological disease.
4. Leaking pus from under the nail plate. In the later stages, severe inflammation begins. A large amount of pus is released. The use of anti-inflammatory drugs and antibiotics in this case does not give the desired effect.
5. Frequent pain at the lesion. When pressed on the finger, they become pronounced. During periods of regular exacerbations, pain intensifies even in a calm state. In the area of ​​oncology, a distinct ripple is felt.
6. Peeling the nail from the base. With the progression of the disease, the plate does not receive the necessary nutrition, therefore, it begins to exfoliate from the finger. All that remains to be seen is a soft cushion modified by the ongoing oncological process.

The presence of two or more signs allows the doctor to suggest that the patient has developed melanoma of the nail of the leg or arm. Sometimes mistakes do occur, for example, a specialist examining a patient confuses this ailment with panaritium, which belongs to the category of infectious diseases.

Types of tumors and characteristics

Melanomas can be of various types. The main types of such tumors are shown in the table:

Types of tumors of the nail plate

Stages of the course of the disease

In the first two stages, melanoma under the nail is quite limited in size. Growing cells do not yet affect the deep tissues and internal organs. The risk of spread is not too high.

In total, there are four main stages of the course of the disease, the main evaluation criterion of which is the thickness of the formation:

• In the first stage, the thickness of the formation is less than 1 mm. The surface of the nail has no obvious damage, ulcers are not detected. When pressed, pain is not felt.
• In the second stage, the thickness reaches 2-4 mm. Small ulcerations appear. Often, tubercles form directly on the nail plate.
• In the third stage, the thickness of the formation is 4 mm or more. Tumor cells already reach the regional lymph nodes, creating secondary foci there.
• In the fourth stage, it doesn’t matter what thickness the tumor has reached. Metastases spread to various organs. The pain is very strong. The size of the tumor grows significantly.

As for pain, they can appear already in the second stage, when the thickness of the growth begins to reach 2-4 mm. However, this does not always happen. In some cases, pain does not occur until the very last stage, until the bone tissue of the finger begins to be completely affected.

The main diagnostic options

It is important at the right time to pinpoint that nail melanoma has appeared. The initial phase of the disease is much easier to treat than the late. To identify a dangerous ailment, special diagnostic measures are used:

• general study of urine and blood tests;
• MRI
• taking tissue for biopsy;
• translucence of the nail plate with a special device;
• the implementation of ultrasound;
• determination of the presence of cancer markers;
• receiving puncture from the lymph nodes.

These options allow you to get certain information, but they are usually carried out in combination. After studying the results, a concrete conclusion is made.

Treatment process

Before proceeding with the treatment of nail melanoma, the presence of metastasis is determined. At the initial stages, the patient appears to be removed by a surgical method. If necessary, healthy tissues located around the affected area are also affected. The phalanx is cut off only in advanced cases.

With the formation of metastases, the effectiveness of treatment decreases sharply. The patient may additionally be prescribed radiation or chemical therapy. Sometimes lymph nodes are subject to removal.

Survival forecast

In assessing the prospects for treating nail melanoma, the stage of disease detection plays an important role. Even if the patient has recovered, it is necessary to monitor the state of health all the time. There is a high risk of relapse. Sometimes, even after a few years, the disease returns.

Five-year survival in the presence of a tumor in percent is expressed as follows:

• At the first stage - 95%.
• In the second stage - 70%.
• In the third stage - 30%.
• At the fourth stage - 7%.

Low survival in the last stages is due to the appearance of metastases, which can occur not only in fingers affected by the disease, but also in other parts of the body.

Final part

To avoid complex and lengthy treatment for nail melanoma, it is necessary to adhere to preventive measures. You should limit your stay in direct sunlight, and avoid bad habits like drinking alcohol and smoking tobacco. In case of suspicious changes in the nail plate, you should immediately consult a doctor.