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Is black discoloration under toenail a sign of skin cancer?

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Posted on Thu, 3 Dec 2015
Question: Hello, my wife find a little black mark with streak line at the right big toe under neath the nail. She is recovered stage 4 lung cancer paient and our concern is that this mark could be a skin cancer. What is your advise to diagnos the symptom. Thanks
doctor
Answered by Dr. T Chandrakant (1 hour later)
Brief Answer:
Please give details and post photographs.

Detailed Answer:
Hi.
Thanks for your query.
Noted your history about your wife recovering from stage 4 lung cancer. Found a little black mark with streak line at the right big toe underneath the nail. Concerned about whether this is a skin cancer.

I would like to have more details please:
- Since when is this noticed?
- Was there any trauma to the toe before noticing this?
- Please see if there is any lymph node enlargement at the groin/inguinal region?

Please post clear pictures so that I can have visual impression.
The advised modality in such a case are:
- Dermatologist's or OncoSurgeon's opinion.
- Trephined biopsy of the black mark and hydrogen peroxide test as it will dissolve the hematoma but not the cancer cells.
- This is basically to be differentiated from the hematoma which appears almost same.

Please give the feedback and post the photograph.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. T Chandrakant (4 hours later)
Appreciate so much for your detail explanation.

noticed three weeks ago

no trauma to the toe

have not found any enlargement

doctor
Answered by Dr. T Chandrakant (7 minutes later)
Brief Answer:
Looks suspicious. Thanks for clear pictures.

Detailed Answer:
Thanks for the pictures.
Such a single spot without obvious injury is definitely a suspicious lesion.

I would advise the following in such a situation as discussed above:
- Dermatologist's or OncoSurgeon's opinion.
- Trephined biopsy of the black mark. In this a drill or a punch is used to remove the small part of the nail above the lesion so that the part of the tissue can be removed and sent for histopathology examination.
- This be done ASAP.

I hope this answers your query and helps in early and proper diagnosis.
Clinical examination by an expert is also equally important.



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

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Is black discoloration under toenail a sign of skin cancer?

Brief Answer: Please give details and post photographs. Detailed Answer: Hi. Thanks for your query. Noted your history about your wife recovering from stage 4 lung cancer. Found a little black mark with streak line at the right big toe underneath the nail. Concerned about whether this is a skin cancer. I would like to have more details please: - Since when is this noticed? - Was there any trauma to the toe before noticing this? - Please see if there is any lymph node enlargement at the groin/inguinal region? Please post clear pictures so that I can have visual impression. The advised modality in such a case are: - Dermatologist's or OncoSurgeon's opinion. - Trephined biopsy of the black mark and hydrogen peroxide test as it will dissolve the hematoma but not the cancer cells. - This is basically to be differentiated from the hematoma which appears almost same. Please give the feedback and post the photograph.