Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

158 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

What causes an unusual painless pigmented spot on the toenail?

Answered by
Dr.
Dr. Kakkar S.

Dermatologist

Practicing since :2002

Answered : 7933 Questions

default
Posted on Thu, 12 Jul 2018 in Skin Hair and Nails
Question: I have had this spot on my toenail for about two months now. I don't remember hurting it and it's painless . what could it be ?
doctor
Answered by Dr. Kakkar S. 50 minutes later
Brief Answer:
Possibility of subungual pigment

Detailed Answer:
Hello. Thank you.
I am Dr kakkar (Dermatologist and Venereologist). I have noted your concern and I have viewed the image.

I would like to know have you noticed it drifting distally? Has it changed since you first noticed it? A subungual pigmentation due to hematoma may develop after a period of vigorous activity or sport where no trauma may be recollected. Another possibility is that it is a pigmented onychomycosis.



Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Kakkar S. 15 minutes later
it has not drifted at all. it has stayed in the same spot and it looks the same. I don't really do sports vigorously or anything. it kinda just is hanging out which is why I got concerned.
doctor
Answered by Dr. Kakkar S. 13 hours later
Brief Answer:
Unlikely to be a Melanoma

Detailed Answer:
Thank you for the information.
I don't think it is a melanoma. A subungual pigment without any communication to the nail matrix or nail folds is unlikely to be a melanoma because functioning melanocytes are only present either in the nail matrix or nail folds but never in the nail bed. Moreover a melanoma of the nail unit usually presents as a longitudinal band that grows with the nail. The fact that it has not changed or changed minimally for 2 months is actually against a melanoma. I suggest you to wait for another 2-3 months and take closeup photos and measure distal drift with a photographic scale. Another possibility is of course of onychomycosis.

Regards
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
premium_optimized

The User accepted the expert's answer

Share on