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Have a brown spot on toenail. Could it be toenail melanoma?

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Practicing since : 2005
Answered : 1391 Questions
Hi there, I have a brown spot on my toenail for over a year now....It's been hidden under my nail polish for months and i just removed the nail polish and was really surprised it was still there!! (I though originally it was a bruise or something)...What could this be? I've done some research and I saw that is could be toenail melanoma??
Posted Fri, 12 Oct 2012 in Skin Hair and Nails
Answered by Dr. Sudarshan 34 minutes later
Hi dear ,

Thanks for writing in.

The condition you are describing can be splinter hemorrhage,melanocytic nevus,longitudinal melononychia or finally melanoma.

Can you upload good quality photos of the affected area.

Also I would like to know-

Is only a single nail involved?

Is there any symptom like pain/itching?

Is the spot of the same size in year?Or is it growing ?

Are you on any drugs presently?

Are you having any skin or other disease?

Please answer the above questions and upload photo to help you better.

MD Dermatologist
Above answer was peer-reviewed by
Follow-up: Have a brown spot on toenail. Could it be toenail melanoma? 2 hours later
Thanks, I've uploaded a picture of both my toes, as it seems the brown patch is starting to appear on the left toe as well (but not as dark as the right toe)

There are no symptoms, it doesn't hurt or itch etc...
In terms of size, because I had nail polish on my toes for the last 6 months, I don't remember exactly...if it has grown, then only by a bit. The other toe (on the left) with mild discoloration is new though.

I am not on any medication at all, and I have no other illness or disease....overall I'm pretty healthy.

Thanks for you help.
Answered by Dr. Sudarshan 22 hours later
Hi dear,

Thanks for the details.

Ive gone through your photo.

Now there can be two possibilities dystrophic nail and onychomycosis( fungal infection of nail) .

NAil dystrophy can be treated by nail avulsion.

For onychomycosis oral and topical antifungals can cure it.It usually takes 3-6 months for cure.

Melanoma is very rare possibilty.It usually involves the adjacent skin fold and when it does it is known as Hutchinsons sign. It is absent in your case.

Still a visit to dermatologist will confirm the diagnosis and will rule out melanoma definitely.

A nail biopsy / nail clipping may be done for confirming diagnosis.
KOH smear will also be helpful.

Hope this helps.

I will be available for any further clarification if needed.


Above answer was peer-reviewed by
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