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What Causes Benign Longitudinal Melanonychia?
Question: I have a longitudinal line in my left index finger for the last 1.5 years atleast. I don't see any rapid expansion of the line but I am not sure about any micrometer increase. One end of the band is blurred. I have consulted one general physician and two dermatologists both say it as a benign longitudinal melanonychia. I hope one of them investigated with a dermatoscope. I was not having any pain before I accidentally read about it online. From then I am in an unrest state and constantly worrying about this. I press it hard to see that I get any pain and constantly do Knuckle Popping with that finger and only this causes pain and I relate this pain to what the colour I have in my finger and keep on worrying. Could it be malignant? I am 24 years old, asian, medium coloured male. One thing I want to add is that now I am in an office job. Earlier I was in a project job in which I used to go to different villages in XXXXXXX to take on infrastructure projects. I took less nutritious food at that time and exposed to sunlight the maximum. Could it be the reason behind that? I am seriously in distress seeing this all time. I want it to go even if it is benign. Please help. Very faded longitudinal lines are present in two or more fingers also. But this one is relatively darker. Is a biopsy necessary? What could be the worse? Would my finger be removed? Also the Internet suggests the morbidity rate is higher and the survival rates are as low as 30% for 5 years. Would I die because of this? If a single finger is diagnosed how it could cause death? I am not overconfident but seriously want to know whats behind this. I could not concentrate in my exams because of this. I even lost a good opportunity to shine. Help me please.
Brief Answer:
You should get well
Detailed Answer:
Hi
Welcome to the site!
I am Dr V XXXXXXX a Sr Consultant Dermatologist. I empathize with you because you are facing a problem that has not been explained and dealt with to your complete satisfaction till date
I will help you to have essential knowledge as well guide you to go for necessary investigations and management.
I have examined your pics as well and think that keeping all the facts stated by you in mind, there is less probability of your problem being malignant and thereby needing any major surgery. However, it is our duty to do all that is possible to keep you safe and healthy.
In order to rule out any risk of spread of the problem, I would advise anyone having similar profile to undergo nail matrix biopsy.It is possible to comment upon the lesion sometimes just on the basis of Dermoscopy. I would be glad to see the reports of Dermoscopy if that is available with you.
Here I would point out that racial, hormonal, traumatic, and association with other skin diseases can too sometimes present in this manner and hope that these have been looked into by the dermatologists that you visited earlier. I would like to know if any other nails too are involved or oral lining or genital linings are similarly affected. Please also inform of any family history of such diseases in the family.
Sun exposure and food habits are unlikely to have caused this.
The details of outcome, amputation, morbidity, and such queries should be deferred for now as these depend upon the outcome of biopsy report. Even in the worst cases, a complete excision of lesions should result in cure. I feel that maintaining a positive attitude will help resolve the issue more effectively. We are going to work together towards your complete recovery.
In the meantime, no special measures are needed except for close observation an a photographic record of the progress.I assume that no staining agents, chemicals, drugs, or hormonal preparations have been used and as such are not correlated to the existing problem.
I am sure, you will supply the required details and together we can handle the problem in the best possible way.
Our best wishes!
You should get well
Detailed Answer:
Hi
Welcome to the site!
I am Dr V XXXXXXX a Sr Consultant Dermatologist. I empathize with you because you are facing a problem that has not been explained and dealt with to your complete satisfaction till date
I will help you to have essential knowledge as well guide you to go for necessary investigations and management.
I have examined your pics as well and think that keeping all the facts stated by you in mind, there is less probability of your problem being malignant and thereby needing any major surgery. However, it is our duty to do all that is possible to keep you safe and healthy.
In order to rule out any risk of spread of the problem, I would advise anyone having similar profile to undergo nail matrix biopsy.It is possible to comment upon the lesion sometimes just on the basis of Dermoscopy. I would be glad to see the reports of Dermoscopy if that is available with you.
Here I would point out that racial, hormonal, traumatic, and association with other skin diseases can too sometimes present in this manner and hope that these have been looked into by the dermatologists that you visited earlier. I would like to know if any other nails too are involved or oral lining or genital linings are similarly affected. Please also inform of any family history of such diseases in the family.
Sun exposure and food habits are unlikely to have caused this.
The details of outcome, amputation, morbidity, and such queries should be deferred for now as these depend upon the outcome of biopsy report. Even in the worst cases, a complete excision of lesions should result in cure. I feel that maintaining a positive attitude will help resolve the issue more effectively. We are going to work together towards your complete recovery.
In the meantime, no special measures are needed except for close observation an a photographic record of the progress.I assume that no staining agents, chemicals, drugs, or hormonal preparations have been used and as such are not correlated to the existing problem.
I am sure, you will supply the required details and together we can handle the problem in the best possible way.
Our best wishes!
Above answer was peer-reviewed by :
Dr. Prasad
I have attached my doctor's report and pictures of my other nails having a very faded line pattern similar to that.
Doctor, I would like to know what is a nail matrix biopsy? Is it something removing my nail? I will grow no nail after that? Is it the only biopsy? Is it the sole test to rule out melanoma? How much does this cost? What will be the complications and steps forward in the report being either benign or malignant?
Even after being benign for years, could it turn malignant, say after 10 years? Removing the nail would cause it to vanish? Will I grow a clean nail after that?
Doctor, I would like to know what is a nail matrix biopsy? Is it something removing my nail? I will grow no nail after that? Is it the only biopsy? Is it the sole test to rule out melanoma? How much does this cost? What will be the complications and steps forward in the report being either benign or malignant?
Even after being benign for years, could it turn malignant, say after 10 years? Removing the nail would cause it to vanish? Will I grow a clean nail after that?
Brief Answer:
Thanks for details
Detailed Answer:
Hi Dear
Welcome back with details.
I have examined your pics.
Here are additional comments on your queries:
Nail matrix biopsy includes deeper part of the nail so that one gets to learn about the process undergoing therein without missing anything.
This involves removing a part of the nail. In fact, just a bit.
The nail usually grows back without any significant remnant of procedure.
This is the best procedure required in such cases. No other investigation will be as contributory as this one
Cost depends upon various factors including location, type of setup, and in XXXXXXX can vary from Rs 2K-4K. However, these can vary widely.
There are complications like bleeding or infection but those are highly unlikely.
Benign lesions can be left as such while malignant lesions need surgical removal.
A benign lesion can turn malignant after any length of time.
Results of surgery are at best predictable to some extent but there is a good chance of complete removal of lesion in most such cases.
It is very likely to regrow clean nail after surgery.
I hope your queries are answered and will do my best to explain anything further should you so desire.
Best wishes
Thanks for details
Detailed Answer:
Hi Dear
Welcome back with details.
I have examined your pics.
Here are additional comments on your queries:
Nail matrix biopsy includes deeper part of the nail so that one gets to learn about the process undergoing therein without missing anything.
This involves removing a part of the nail. In fact, just a bit.
The nail usually grows back without any significant remnant of procedure.
This is the best procedure required in such cases. No other investigation will be as contributory as this one
Cost depends upon various factors including location, type of setup, and in XXXXXXX can vary from Rs 2K-4K. However, these can vary widely.
There are complications like bleeding or infection but those are highly unlikely.
Benign lesions can be left as such while malignant lesions need surgical removal.
A benign lesion can turn malignant after any length of time.
Results of surgery are at best predictable to some extent but there is a good chance of complete removal of lesion in most such cases.
It is very likely to regrow clean nail after surgery.
I hope your queries are answered and will do my best to explain anything further should you so desire.
Best wishes
Above answer was peer-reviewed by :
Dr. Prasad
Doctor, thank you for your reply. Shall I leave it free as advised by the dermatologists? Am I over fearing? In future if it gets any worse, then at that time I go for a biopsy? In the mean time, shall I go to the dermatologist whom I consulted every six months? If she asks me to go for a biopsy, then at that time I go for it? Because she said you donot even need a second consultation, it is just a benign one.
Brief Answer:
We need to do what is in your best interest
Detailed Answer:
Dear Sir
I appreciate your responses.
I am of the opinion that while deciding to take some action, one should know what one is dealing with. Leaving the problem diagnosed has attendant risks.You are not over fearing but are concerned.
Being concerned about health is a plus point while worrying may not be so.The decision to go for a biopsy depends upon personal preferences as well.Your dermatologist is one of the best persons to guide you and will advise you about the next steps.
I wish you never had the problem but since it is bothering, you need specialist help to cope up. I am concerned that you should get well soon.
I hope you will decide what is best for you in the light of available information.
Our best wishes, always!
We need to do what is in your best interest
Detailed Answer:
Dear Sir
I appreciate your responses.
I am of the opinion that while deciding to take some action, one should know what one is dealing with. Leaving the problem diagnosed has attendant risks.You are not over fearing but are concerned.
Being concerned about health is a plus point while worrying may not be so.The decision to go for a biopsy depends upon personal preferences as well.Your dermatologist is one of the best persons to guide you and will advise you about the next steps.
I wish you never had the problem but since it is bothering, you need specialist help to cope up. I am concerned that you should get well soon.
I hope you will decide what is best for you in the light of available information.
Our best wishes, always!
Above answer was peer-reviewed by :
Dr. Sonia Raina
Thank you doctor. Then I would consult my dermatologist every six months and get my nail tested. In any point of time she suggests me to go for a biopsy, I go for it.
Thank you again for your kind response.
Thank you again for your kind response.
Brief Answer:
welcome
Detailed Answer:
Hi
You are welcome.
Best wishes
welcome
Detailed Answer:
Hi
You are welcome.
Best wishes
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Sonia Raina
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