Subungual melanoma: definition, causes, symptoms and treatments

Mélanome ongle pied traitement et symptômes : tout savoir

Among the cancers that affect the skin at the nail level, subungual melanoma stands out by its rarity. It is therefore one of the least known tumors by the population, but the most dangerous. Fortunately, it can be treated until it is completely cured, especially when it is detected early. What is subungual melanoma? What causes it? What are its symptoms? How can this tumor be treated? Find the answers in this article.

What is subungual melanoma?

Melanoma is a cancerous skin tumor that develops from pigmentary cells of the epidermis, the melanocytes. When it develops under a nail, it is called subungual melanoma. Like malignant lesions, it develops in an uncontrolled and unlimited manner. It can then infiltrate the surrounding epidermal tissues, which leads to metastases capable of affecting all the organs of the body. This skin cancer is not the most common, but it remains the most known by scientists and even the most dangerous.

What causes subungual melanoma?

The actual cause of subungual melanoma is not yet known. However, research has identified several risk factors for its growth. Among others, these are:

  • Previous toe-related concussion;
  • Family or personal history of the tumor;
  • Miscellaneous moles;
  • Genetic factors(hereditary xeroderma pigmentosadisease );
  • Immune suppression.

Contrary to what one might think, ultraviolet (UV) radiation is not a factor in the development of a tumor under the nails on the feet.

What are the symptoms of subungual melanoma?

Les symptômes d’un mélanome sous-unguéal

Subungual melanomas appear as dark streaks that run perpendicular to the cuticle. It should be noted that half of these striae are of various colors (black, blue, brown) and the other half are not pigmented. Moreover, as the cancer progresses, several other striae are likely to appear and of different colors. It is even possible that the one close to the cuticle will widen. This makes it easier to differentiate subungual melanoma from other types of toenail disorders.

In addition, when melanoma develops, it can lead to :

  • Bleeding;
  • Nail deformity;
  • Nodule formation.

When these symptoms are observed, it is advisable to consult a health professional for diagnosis and treatment.

What treatment is needed to stop the growth of subungual melanoma?

When subungual melanoma is diagnosed, there are several treatments that can be applied depending on its stage of evolution. The first is surgery of the cancerous tumor. Depending on the extent of the lesion, it is possible to preserve the toenail matrix. However, when the lesion affects the surrounding tissue, more radical surgery may be required. When the cancerous tumor is not quickly diagnosed, lymph node dissection may be necessary. This operation consists of removing the lymph nodes that are in the vicinity of the cancer. It also allows for better adjustment of the treatment by providing information on the extent of the tumor.

In addition, when lymph node invasion is present, other treatments will be necessary to complement the surgery. These treatments are chemotherapy and adjuvant radiotherapy, the purpose of which is to reduce the risk of recurrence and to make the patient more comfortable. Finally, stereotactic radiotherapy is more indicated when distant metastases are limited.

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