Melanoma under the big toenail symptoms. Symptoms and treatment of subungual melanoma. Symptoms and Causes in Children in Adults

Subungual melanoma is a type of cancer characterized by dysplasia of melanocytes located under the nails. The disease occurs in 4% of the total number of cancers, and in the initial stages it is treatable. The risk group includes people who often injure their nails or suffer from fungal infections. The neoplasm has a bluish tint, which is easy to confuse with a hematoma, without giving due attention to serious pathology.

It is not known for certain what is the root cause of abnormal cell division, but some prerequisites have been established that can affect this process:

1. Pathologically reduced immunity, against the background of which a number of inflammatory and infectious diseases progress, which is completely impossible to get rid of. It has been proven that people with immunodeficiencies are more susceptible to developing melanoma than patients with good health.
2. Light skin exposed to the harmful effects of ultraviolet rays. People with pale skin and blond hair are at risk.
3. The presence of age spots caused by excessive sun exposure.
4. The presence on the skin of neoplasms of various etiologies, which are constantly increasing in size.
5. Presence of skin cancer in blood relatives.
6. Frequent injuries to the nail plate, in which it exfoliates.
7. The presence of constant contact with chemicals, which provokes the development of chronic intoxication.
8. Poor nutrition, devoid of nutrients.
9. Alcohol and smoking abuse.
10. Wearing tight and uncomfortable shoes, which provokes constant squeezing and deformation of the nail plate.

The main reason for the development of cancer is uncontrolled cell division, which occurs under the influence of many factors, interrelated with each other.

Types of subungual melanoma

Considering the external clinical manifestations and morphological signs, subungual melanoma can have several subspecies:

1. Longitudinal - looks like a longitudinal strip of dark color, dividing the nail vertically into two equal halves. Most often found in blacks. People with fair skin hardly experience this type of cancer. It develops due to excessive accumulation of melanin in the nail, the excess of which has a detrimental effect on the processes of cell division. The danger of the disease is that it progresses very quickly, depriving a person of the possibility of recovery.
2. Acral - formed in the nail bed, having a purple-black color. The danger of neoplasms is that external manifestations are almost impossible to distinguish from the consequences of a bruise. The nail plate becomes bluish and sore. The disease progresses very quickly. In the absence of diagnosis and comprehensive treatment, acral melanoma entails amputation of a toe or leg, which ultimately leads to death.
3. Periungual melanoma - the tumor can be located on an extremity, giving metastases to the nail matrix, which leads to the rapid growth of the tumor. Complete damage to the limb requires amputation, after which chemotherapy is prescribed to prevent further spread of metastases in the body.

Subungual melanoma most commonly affects the toenail. Initially, external clinical signs indicate a bruise, under the mask of which cancer cells grow at a tremendous rate. Only early diagnosis will make it possible to correctly diagnose and save the limb. Otherwise, amputation cannot be avoided.

The danger of subungual melanoma is that it can grow into the deep layers of the skin in the shortest possible time, completely affecting the limb. At the same time, the clinical picture remains scarce. There are cases when subungual melanoma has grown into the sole of the foot without specific signs, provoking an advanced form of cancer, leaving no chance for a person to live.

A distinctive feature is the fact that bruise-like symptoms do not go away after 10-12 days, as is typical for trauma. The neoplasm under the nail plate is rapidly increasing in size, changing the color to rich purple, which requires immediate attention to a specialist.

The most dangerous type of subungual melanoma is acral. This form is characterized by the rapid growth of cancer cells, as well as accelerated metastasis. With the blood stream, cancer cells are carried to distant organs, which requires high-dose chemotherapy.

The development of subungual melanoma occurs in several stages, which characterizes the degree of the oncological process:

1. The appearance on the nail plate of a dark spot with splashes, the color of which varies from dark gray to deep purple.
2. The stain grows over several weeks and spreads to the entire surface of the nail plate. Any touching and walking cause severe pain. The finger may go numb.
3. Damage to the nail fold, after which the nail becomes loose and stops growing. With awkward movement, complete or partial discharge of the nail plate is possible.
4. The appearance of bleeding ulcers that extend to the entire toe. The patient's condition is rapidly deteriorating. Fine motor skills and gait are impaired. In the absence of qualified assistance, death can occur before the diagnosis is made.

It is important to control the symptoms of injury. In the absence of natural regeneration, you should immediately contact a specialist. Further delay can cost your life.

Diagnostic methods

Cancer detection is carried out in three stages:

1. Examination of the nail under a dermatoscope - with the help of a special microscope that can see through the nail plate, the neoplasm is examined, revealing its size, shape and depth of germination.
2. Biopsy - a part of the neoplasm is excised, and then examined by a histological method, revealing the presence of cancer cells. If different parts of the body are damaged, a biopsy is taken separately. There are cases when the same symptoms have a different etiology.

Histology allows you to differentiate subungual cancer from diseases such as:

• fungal infection of the nail plate;
• hematoma of the nail after injury;
• purulent granuloma;
• squamous cell carcinoma.

It is impossible to make an accurate diagnosis without a biopsy. Even experienced specialists cannot distinguish a neoplasm from a hematoma.

In the presence of an advanced form of cancer, a biopsy of the lymphatic fluid of a nearby lymph node is mandatory. This is necessary to assess the risk of metastasis and confirm the degree of cancer progression, which affects the choice of treatment and further prognosis.

Treatment methods

Treatment consists in complete excision of damaged tissues, as well as complex therapy that prevents the development of relapse. The degree of excision directly depends on the depth of the nail lesion.

In the case when a biopsy of the lymph nodes has confirmed the presence of metastases, high-dose chemotherapy is prescribed in several stages, after which the affected area of \u200b\u200bthe limb is amputated.

The most common treatments are:

1. Exarticulation of the phalanx of the finger - the task of the procedure is to maximize the preservation of viable tissues and to remove only the damaged areas of the nail plate and phalanx of the finger. It is produced under local anesthesia, with the help of which the area around the phalanx is injected. A tourniquet is applied to help reduce possible bleeding during disarticulation. Excision is performed in stages, after which securing sutures are applied. Further treatment requires the use of antibiotic therapy and pain relievers to facilitate the postoperative period.
2. Amputation of the distal phalanx - the procedure involves the removal of the phalanx of the finger along with the affected nail plate, which is carried out under local anesthesia. First, the skin is excised, which in the future will form the stump. Next, tendons and ligaments are excised, after which they proceed to sawing bone tissue. After suturing, a splint is applied to the finger, completely immobilizing. Constant dressings are required to avoid the development of the inflammatory process.
3. Amputation of the foot or hand is prescribed in the presence of tumor invasion into the deep layers of the dermis, which cannot be eliminated with distal amputation. This leads to disability, but allows you to save life. In the future, it is possible to use a prosthesis.
4. Chemotherapy - cytotoxic drugs kill cancer cells by blocking their growth. However, all organs and systems suffer from aggressive drugs. Full-scale intoxication provokes the development of a mass of adverse reactions that pass over time. With the help of chemotherapy and amputation of the affected area of \u200b\u200bthe nail, good results can be achieved, but subungual melanoma is prone to relapse in the first year.
5. Immunotherapy - drugs that strengthen the immune system, reduce the aggressiveness of the tumor, but do not contribute to its complete destruction. Immunotherapy can be included in the complex therapy in the presence of pathologically reduced immunity. It is usually given after high-dose chemotherapy to help the body recover as quickly as possible.

The duration of treatment depends on the degree of cancer, as well as the individual characteristics of the organism. For some people, it is enough to partially remove the affected nail, while for others, even chemotherapy does not help.

Prevention

As a prevention of the development of subungual melanoma, it is recommended:

1. Choose the right shoes that do not squeeze your toes. This is especially true for women who, in pursuit of fashion, try to wear tight shoes that provoke an incorrect position of the nail plate.
2. In the presence of nail injuries and long-term persistence of signs of damage, seek professional help. Early diagnosis can rule out cancer and, if present, reduce the risk of death.
3. Strengthen immunity with the help of vitamin complexes, as well as reduce the frequency of visits to public places with high humidity, where you can "catch" fungus, HPV and other unpleasant diseases that are a predisposing factor for the development of melanoma.
4. Do not mask the problem with cosmetic varnish. Cancer devoid of attention is constantly progressing, taking away precious years of life.
5. If you have a predisposition to cancer, visit a dermatologist twice a year, and if you have suspicious neoplasms, do not delay the diagnosis.
6. Lead an active lifestyle that strengthens the entire body. Proper nutrition and physical activity will help resist the development of pathological processes in the body.
7. Give up bad habits and alcohol, which together reduce the protective properties of the body.
8. Observe the rules of personal hygiene, as its absence can provoke the development of fungal diseases.
9. In the hot season, exclude exposure to the open sun from 10 to 16 hours, and in urgent need, use protective clothing covering the body.
10. Refuse to visit the solarium, since in pursuit of fashionable tendencies of light tanning, you can provoke the development of oncological processes in the body.
11. Do not use cosmetic scissors or tongs, or other person's shoes.

It is impossible to prevent the development of cancer. In the world there are no such vaccines and ways to prevent abnormal cell degeneration. Therefore, it is best not to ignore any suspicious changes in the body.

Forecast

In the presence of an early stage of cancer, the survival rate is 80%. However, this type of cancer is prone to recurrence and metastasis, which aggravates the situation. Life expectancy depends on many factors, averaging 10-15 years.

For the second stage of oncology, the forecasts are less reassuring. It is possible to cope with deep lesions of the epidermis and metastases in the lymph nodes only after a long course of high-dose chemotherapy. The body does not always cope with such loads.

The third and fourth stages are almost hopeless. The patient's limb is amputated, but metastases spreading to all organs with blood flow ultimately provoke death. The unfavorable prognosis once again underlines the importance and necessity of self-control. Any wounds, abrasions, cracks, neoplasms and bruises that do not go away after 10-12 days are a reason to see a doctor.

Cancer progresses very quickly. In just a couple of weeks, from an initial and almost harmless form, it develops into an advanced stage, provoking the development of metastases in vital organs. The earlier the pathology is detected, the more chances it will be cured with minimal consequences for the body.

This is the name of the malignant degeneration of pigment cells - melanocytes. It is known that the disease can affect the skin. However, there are cases when abnormal cells can form under the nail.

The disease is quite rare. It occurs somewhat more often in men than in women. The growth of such a tumor occurs much faster than other malignant neoplasms, which explains the high mortality rate from this disease. Melanoma of the nail has several varieties:

1. A tumor that grows out of the nail matrix.
2. Melanoma that forms under the nail plate.
3. A tumor that grows on the skin next to the nail plate.

Melanoma causes

Melanoma of the skin in open areas, as a rule, develops at the site of a mole or nevus under the influence of ultraviolet radiation. Experts noted several factors that could affect the transformation of cells into malignant ones:

1. Nail trauma, even long-standing. It can be bruised, burned, squeezed, scrapped.
2. Genetic predisposition to pathology.
3. Frequent exposure to sunlight or UV radiation in a solarium.
4. Elderly age.
5. The presence of bad habits and weak immunity.

More susceptible to the development of melanoma under the nail are fair-skinned, red-haired people and people with a large number of birthmarks and age spots, moles and freckles.

The tumor can be localized under the nail plate, affect the nail fold, or form on the skin next to the nail. Outwardly, the disease looks like a dark spot on the skin with uneven edges and irregular shape.

It is often confused with panaritium or hematoma. The color of the formation varies from light brown to dark brown.

You can also observe shades of burgundy and purple.

Age, gender, or skin color doesn't matter for melanoma. This disease can affect anyone. That is why it is so important to know the reasons that contribute to the development of melanoma. Experts do not yet know the exact reasons provoking the development of the disease. The factors that increase the chances of getting sick are:

The reliable cause of the development of melanoma has not been established. But doctors point to the existence of risk groups, among which skin cancer is more common. This category includes people with the following characteristics:

Absolutely everyone can get nail oncology, regardless of age, skin color, race and other characteristics.

Etiology and types

Melanoma is an atypical degeneration of melanocytes or pigment cells. The disease affects the human dermis, but, in rare cases, abnormal cells can appear under the nails.

The disease is considered rare; men suffer from it more often than women. Subungual melanoma is characterized by rapid growth and high mortality.

Melanoma of the nail is divided into several types and categories.

Types of disease:

• formation that affects the nail matrix;
• a tumor localized under the nail plate;
• melanoma on the skin, next to the nail plate.

All of these species pose a danger to human life. In terms of the number of deaths, the disease is the leader among skin cancers.

Melanoma can develop from the nail matrix or originate on the skin near the nail plate. There is also acral nail melanoma or melanonychia. It appears on his bed and is a dark line located longitudinally. It is often mistaken for an ordinary bruise and is not sought for help until it is too late. Symptoms to watch out for:

• the nail plate quickly changes color;
• the nail is undergoing changes;
• when pressing on the plate, pain appears;
• a crack appears along the nail.

Depending on the localization of the malignant process, the following cancers of the nails are distinguished:

1. Melanoma of the nail plate.
2. Subungual melanoma, actually.
3. Melonoma, the development of which occurs from adjacent tissues.

Possible stages

As mentioned above, there are 4 stages of nail melanoma. Let us consider in more detail the signs and characteristics of each phase of the disease.

Melanoma under the nail develops gradually. At first, this disease may be completely invisible or "disguised" as another problem. Often, patients go to the doctor when it is too late - at the third or fourth stage of the development of the disease. There are four stages of cancer development.

The presence of moles and age spots requires a person to regularly monitor their condition. If abnormal changes in the structure of the nevus are found, it is necessary to immediately consult an oncologist.

In oncological practice, two main methods of therapy are used to treat melanoma in the early stages:

1. A surgical procedure that removes all cancerous tissue.
2. A complex technique that includes surgery and radiation therapy. The combination of surgical excision of the tumor and radiological technique gives the most favorable results and the chances of cancer survival... Radiation exposure through the use of highly active X-ray radiation allows the destruction of possible cancer cells in the lymph nodes.

Radiological treatment is used in the form of remote irradiation of the tumor before surgery. This is necessary to stabilize the malignant process and prevent recurrence of the disease.

Patients with stage 1 oncology have a positive prognosis of five-year survival - more than 80%. Stage 2 cancer reduces survival by up to 55%. What do these indicators mean?

For example, a survival rate of 80% means that after treatment, 80% of patients survived 5 years or more without relapses and complications. The third stage of nail melanoma with metastases to the lymph nodes reduces the prognosis to 30-40%. At stage 4, the prognosis is the least favorable - only 15%.

Modern medicine can successfully fight melanoma in the early stages of the development of the disease. Therefore, be careful about your body and regularly examine your body.

If you notice pigment defects on it that change size or shape, then immediately contact a dermatologist or oncologist.

Signs of nail melanoma

Symptoms of subungual melanoma change with the course and progression of the disease. Therefore, it is important to notice its first signs in time. Namely:

1. The appearance of a small pigment spot that has formed under the nail plate. The spot may be in the form of a small longitudinal strip on the nail bed. Sometimes the appearance of subungual melanoma is preceded by a small finger injury, due to which the patient did not consult a doctor in a timely manner.
2. An increase in the stain under the nail (usually within a few weeks or months). It becomes wider, especially in the cuticle area, changes color to dark or light brown.
3. The spread of education on the nail roller.
4. The development of nodules and the appearance of bleeding ulcers, leading to thinning, cracking and deformation of the nail plate (nail dystrophy).

As the malignancy develops, the entire nail is affected.

The presented type of melanoma accounts for 10% of the total number of tumors. Neoplasms occur with the same frequency in people of any race (you can see how it looks on the skin in the photo). Moles do not precede the development of the lesion.

If melanoma is noted on the nail bed, its sign is the presence of a brown longitudinal line. The tumor cannot be felt by touch until it enters the stage of vertical growth.

The nail plate begins to rise above the finger, more of the symptoms should be noted:

• persistent paronychia;
• painful sensations;
• dystrophy of the nail plate;
• increased pigmentation;
• longitudinal splitting of the nail.

Symptoms of nail cancer

Some people are worried about whether an ordinary mole can become a tumor. In some cases, this is the case. Often a person notices that a mole has appeared on the skin near the nail. It could be melanoma.

Cancer of the nail has striking characteristic features. The initial stages of the disease often occur without pronounced clinical symptoms, which complicates early diagnosis and timely treatment.

If you notice a characteristic darkening of the nail plate or the appearance of a dark area near it, rush to the doctor: this change may indicate that a cancerous tumor of the nail is developing in the body.

The common symptoms of nail cancer are as follows:

1. The appearance of a characteristic dark or black spot on the nail. It grows very quickly and sometimes splits the nail exactly in half.
2. Darkening of the nail bed (this is the first and earliest sign of malignant nail cancer).
3. Cancer covering the entire nail plate (this rarely happens at stage 1, it usually happens in a few months).
4. Be careful: sometimes not only black, but also blue, brown and even purple formations appear on the nail plate.
5. If you damage the nail plate, then bleeding is possible.
6. The nail plate is eroded and destroyed due to ulcers.
7. Purulent contents are released from under the nail plate.

Melanoma in the foot can spread to the sole. This process leads to severe walking difficulties. Sometimes a person cannot stand on the affected leg at all.

The disease is quite rare. Slightly more common in men than women

Characteristics of this melanoma

The early stages of this disease are quite insidious. This is due to the fact that the doctor may confuse them with hematoma or subungual panaritium.

The further course of the disease causes the appearance of a mushroom formation on the nail plate. Finally, the nail is completely affected and flakes off.

Such phenomena indicate a neglected disease. Treatment of advanced forms of this disease is very difficult.

The rate of development of nail plate melanoma can vary significantly. With the slow progression of cancer, metastases appear at the very late stages.

There is also a fulminant form of melanoma, when metastases with blood flow extremely quickly spread to distant organs. Usually, palliative treatment is prescribed for such patients.

The following symptoms indicate tumor metastasis:

• the appearance of a tangible seal under the nail plate;
• the presence of a chronic cough;
• change in skin tone (it becomes dull, ashy);
• the patient's body temperature rises;
• the nail is almost completely destroyed and bleeds;
• seizures develop;
• lymph nodes are enlarged and thickened;
• weight loss (sometimes even to cachexia).

What is melanoma and how to detect it yourself (video)

How the disease progresses

Subungual melanoma has its own specific features by which it can be distinguished from other pathologies. As the disease progresses, symptoms begin to change, and a minor defect becomes a visible neoplasm.

• a small pigmented spot or strip under the nail plate;
• the defect does not go away, unlike a hematoma after two weeks;
• the age spot increases in size;
• a color change occurs up to black or dark brown;
• the edges of the defect begin to bend;
• education moves to the nail roller;
• cracks, bleeding wounds, nodules appear on the roller;
• the nail plate is deformed.

Important! Subungual melanoma does not always change color. The disease can develop for a long time, without any symptoms. There are cases when nail melanoma spread to the sole.

In the initial stages, this pathology is very insidious. This is due to the fact that the disease can be confused with the usual hematoma or nail felon.

The tumor growth rate changes frequently. With slow development, metastasis occurs at the last stage of the pathology, and with rapid progression, metastases are spread by blood to distant organs.

The process of metastasis can be determined by the following signs:

• a noticeable seal under the nail;
• chronic cough;
• skin color becomes gray, dull;
• high body temperature;
• the nail collapses and begins to bleed;
• convulsions appear;
• lymph nodes increase;
• the patient's weight is sharply reduced.

Most often, this disease is found in the area of \u200b\u200bthe big toe or toes - it is usually deployed not on the nail, but on the skin under or next to it. Gradually, the disease develops, spreading throughout the nail plate. You need to sound the alarm in the following cases:

• a dark spot grows on the nail plate (it darkens completely in a month or two);
• painful sensations appear when pressed;
• hematoma under the nail does not go away within 14 days;
• bleeding in the nail area, the appearance of pus;
• color: red, purple, brown and up to purple and black;
• sores under the nails.

The primary manifestations of subungual melanoma are virtually absent, and only during the development of a cancerous lesion is the external manifestations of the tumor detected in the form of:

• The presence of a small brown spot that is located at the base of the nail bed. In some cases, the nail lesion may develop as a longitudinal strip on the nail. From time to time, before the origin of external manifestations, patients note a finger injury, for which timely medical care did not appear.
• In the later stages of the disease, the age spots increase in size and the color becomes much more intense.
• During growth, a malignant neoplasm spreads to the entire nail plate and adjacent soft tissues.
• The terminal stages of the disease are accompanied by the formation of a nodular lesion of the nail tissue, followed by ulceration and the origin of spontaneous bleeding.

Considering the rate of development and growth of this malignant skin lesion, early detection of the tumor is very important for successful treatment. Accurate diagnosis is difficult because melanoma is easily confused with a common nail injury.

At the initial stage, this malignant formation is often mistaken for a hematoma after injury, paronychia (suppuration) or panaritium (inflammation of the periungual ridge).

Therefore, it is necessary to know the main symptoms of this dangerous disease:

Most often, melanoma is found on the large nails of the hands or feet. A swelling on the toenail is more dangerous. The neoplasm does not develop on the nail plate, but under it or next to it in the skin.

While developing, it spreads to the entire nail plate. The main symptoms of melanoma are as follows:

• a dark spot appears on the nail, gradually increasing in size;
• the appearance of the spot may be preceded by trauma (if there is a hematoma under the nail, then it will pass within 2 weeks, if it does not go away, then you need to contact the oncology department);
• in a few months, the spot under the plate can completely cover it;
• when feeling the nail, painful sensations and bleeding are possible;
• tumor color - black, purple, brown heterogeneous, dark purple, red;
• ulcers appear under the nail, undermining it;
• purulent discharge is possible.

Acral nail melanoma deserves special attention. This species develops on the nail bed. The main symptom of an acral tumor is a black longitudinal line on the nail, as in the photo.

The disease is often confused with a bruise, which is why they do not seek medical help on time. It is impossible to feel the tumor until it passes into the malignant stage of vertical growth. The symptoms of such melanoma can be described as follows:

• degeneration of the nail plate;
• color change;
• painful sensations;
• the growth of a pigmented defect;
• longitudinal splitting of the plate.

The nail tumor changes its behavior depending on the stage of development:

1. At the first stage, its thickness does not exceed 1 mm, it is not palpable and does not bother.
2. On the second, the thickness increases to 2 mm or more, the tumor changes color and spreads along the nail.
3. On the third, cancer cells are separated from the primary focus, after which they spread to the nearest lymph nodes (cancer begins to metastasize).
4. On the fourth, metastases appear in vital internal organs.

Based on the above, it can be concluded that nail melanoma is easiest to treat at the initial stages of its development. But first you need to diagnose it.

To do this, the patient must contact an oncologist, who will prescribe a number of tests, such as a visual examination, a blood test, and a histological examination. If a malignant tumor is detected, additional studies are prescribed in the form of ultrasound of internal organs and tomography.

Diagnosis of the disease

The danger of nail cancer is also that it is extremely difficult to diagnose. After all, the characteristic signs of the disease do not always appear.

Due to the asymptomatic nature of the initial stages of such a disease, people do not go to the doctor. Meanwhile, the beginning of treatment at the earliest stage is highly effective.

That is why it is necessary to regularly inspect the nail plates. If suspicious changes appear, you should immediately contact an experienced dermatologist.

Self-examination should be carried out every month: this frequency allows you to notice the beginning of the moment when melanoma grows.

First of all, the patient is tested for tumor markers. With the help of a dermatoscope, translucent the stratum corneum of the skin and nail, the specialist determines whether it is a malignant tumor or not.

Next, a biopsy is prescribed - part of the tumor tissue is removed for further laboratory examination. This histological examination puts an end to the diagnosis: it confirms the malignancy of the neoplasm or diagnoses another disease (for example, hematoma, fungus, granuloma, etc.).

Having determined the diagnosis, the doctor prescribes the necessary medical measures.

Since subungual melanoma may not have typical symptoms, any change in the pigment group of the nail plate, and especially an increase in its size (up to 3 mm or more), should be a reason for going to the doctor.

To determine if a tumor under the nail is malignant, doctors use a dermatoscope - a special microscope that shines through the stratum corneum of the nail and skin.

If dermatoscopy has determined a malignant origin, then the patient is assigned an additional histological examination (biopsy), which involves the removal of a suspicious formation together with a portion of the surrounding skin or nail matrix and laboratory examination of tissue sections under a microscope.

It happens that a laboratory analysis of an excised formation can refute the presence of a subungual melanoma in a patient, diagnose other diseases, which may be: a subungual hematoma (which is formed due to bruising or bleeding), fungal infection, paronychia, purulent granuloma, squamous cell carcinoma.

Hiding the problem under a layer of varnish is not the best way out of the situation.

If there are suspicions of nail cancer, then the primary diagnosis of a malignant nail lesion should be carried out under the supervision of not only a dermatologist, but also under the supervision of an oncologist.

Because the manifestations of the disease in the early stages are similar to the manifestations of traumatic damage to the nail plate, dermatoscopy should be performed.

Examination of the affected area with a magnifying device allows you to find out the presence of malignant tissues in the nail bed. If a dermatologist suspects a cancerous process, then a biopsy is considered the next stage of diagnosis.

To determine the malignant nature of the neoplasm, dermatoscopy is used (scanning the nail with a special microscope). Also, a blood test is taken to establish the presence of tumor markers (proteins that appear in the blood of a person in the presence of cancer).

To determine metastases and other associated pathologies, ultrasound, tomography and radiography are used.

The most accurate determination of the nature of the nail lesion can be given by histology, but before removal of the tumor, the use of biopsy is avoided, since it can cause acceleration of metastasis.

Attention should be paid to the condition of both congenital and acquired moles. If you have any suspicions, you should immediately contact a specialist.

The following signs should alert you:

• an increase in the size of the neoplasm;
• color change;
• changing boundaries;
• the presence of ulceration;
• bleeding;
• pain and itching;
• hair loss.

At an early stage, the diagnosis is carried out by dermatoscopy. A specialist examines the nevus using a microscope or magnifying glass.

Dermatoscopy allows you to determine the presence of the disease at an early stage of development

The following symptoms are taken into account:

• size over 6 millimeters;
• asymmetry;
• discoloration;
• uneven edges.

A blood test for specific markers is not used. Biochemical and general analyzes are used only to determine the condition of the kidneys, liver and bone marrow during therapy. An analysis can be used to determine the level of lactate dehydrogenase - if it is high, melanoma is difficult to treat.

The final verdict is made after the histological analysis of the neoplasm. Melanoma is excised along with the surrounding healthy tissues. A biopsy is not used to prevent the tumor from growing.

Additional diagnostic methods: scan of the brain and bones (the verdict is made on the received photo), chest x-ray, and liver function tests. CT and scintigraphy are used to detect metastasis.

Feet - one of the places where acral melanoma develops

Treatment

Cancer treatment involves the removal of the neoplasm along with the stratum corneum, affected skin, tissue and fatty layer. With deep lesions, the phalanx of the finger is amputated.

And also a lymphadenectomy is prescribed after gamma therapy. Chemotherapy or radiation therapy is used as palliative care.

If the tumor was diagnosed at the initial stage, then only the nail plate and a few millimeters of tissue under it are excised. In the first stage of melanoma, the lymph nodes are not removed.

When diagnosing this disease, it is necessary to completely remove the lesion. The complete removal of the melanoma is performed surgically, together with the muscle and subcutaneous fatty tissue, sometimes together with the nail. In more advanced cases, with the formation of bleeding ulcers, doctors decide to completely amputate the phalanx on the toe or hand, and when metastases appear, a course of chemotherapy is prescribed.

Melanoma is treatable in the first two stages. It is removed by capturing adjacent healthy tissue: muscle and fiber.

In the event that the disease has spread greatly, the treatment consists in removing the whole nail or even amputating the phalanx. The procedure is performed under general anesthesia, so the patient practically does not feel anything.

If a nail was removed during the procedure, do not worry too much. The wound will go away in a maximum of a month, and the nail plate will recover.

This usually takes 6 to 12 months.

Patients with melanoma also undergo histological examination of the lymph nodes to rule out the spread of the disease. If the cancer has got there, the nodes are also removed.

In the presence of multiple metastases, chemotherapy or radiation therapy is performed, which should remove cancer cells from the organs. This procedure is quite exhausting for the body.

Treatment of nail melanoma means complete removal (excision) of the melanoma by surgery, together with the muscle and subcutaneous fat. Sometimes, if the melanoma has spread strongly, the entire nail is removed with it, and in advanced cases, doctors decide to amputate the phalanx of a finger or toe.

Also, patients with nail melanoma are usually given a lymph node biopsy, which is required to determine the extent of the melanoma (this is how doctors determine whether the melanoma has spread to local lymph nodes).

If metastases in the lymph nodes were found, then surgical treatment is complemented by regional lymphadenectomy (removal of lymph nodes) and complex or combined treatment is prescribed individually.

Successful treatment of melanoma is possible only with timely diagnosis.

The key method of treating a malignant nail lesion is an operation to remove a tumor and a part of healthy nearby tissues for prophylactic purposes.

The amount of timely intervention determines the prevalence of the pathological focus. So in the primary stages of the disease, the removal of cancerous tissues can be carried out through the action of ultra-low temperatures, which lead to the exfoliation of mutated cells.

Before cryosurgery, the patient is removed the nail plate.

In cases of a large spread of oncological lesions of the nails with the spread of the process to neighboring tissues, the patient is recommended to amputate the digital phalanx.

Additional treatments for nail melanoma include:

The use of cytostatic drugs is prescribed in the preoperative period to stabilize the malignant process and prevent the origin of recurrence at the end of the operation.

The action on the tumor with highly active X-rays leads to the death of cancer cells and possible metastatic lesions of the lymph nodes. The use of radiation is recommended as the last step in the timely treatment of advanced subungual melanoma.

Subungual melanoma is treated surgically by removing the tumor along with the affected nail plate, muscle tissue and subcutaneous fat cells. The amount of tissue removed is determined based on the size and extent of the lesion.

After the operation, a histological examination of the tumor sample is performed. Sometimes complete removal of the nail or amputation of the phalanx of the finger is used. If the lymph nodes are affected, lymphadenectomy is also performed - removal of the affected area with metastases.

After the operation, if necessary, appoint:

• chemotherapy (the use of potent drugs);
• radiation therapy (local dosed radiation);
• immunotherapy (the use of immunomodulatory vaccines or serums to activate the body's defenses).

During the rehabilitation period, it is important to take restorative agents.

First of all, the tumor is removed surgically. At the same time, healthy tissue is also excised in diameter - about 3 cm from the edge of the melanoma. Additional treatment is selected based on the thickness of the neoplasm.

If a large wound remains after excision, it must be closed with a valve or graft. When the cancer is located under the nail, in some cases, part of the finger is removed.

Sometimes, on the contrary, not the entire tumor is removed, despite its large size. In this option, subsequent surgery or radiation therapy can be applied to completely get rid of the neoplasm.

Removing part of the limb is necessary to prevent recurrence of the disease

Treatment is prescribed only after a thorough diagnosis. It can be different and depends on many factors: the stage of the cancer, the presence of metastases, etc. First of all, the neoplasm under the nail is surgically removed.

Preventive measures

Treating this type of melanoma is not an easy task, but the disease can be prevented:

• do not abuse sunbathing and visits to the solarium;
• eradicate bad habits;
• monitor the state of the immune system;
• regularly conduct self-examination of nails on the hands and feet, and if any changes occur, consult a doctor;
• after a finger injury, observe the duration of the presence of a hematoma under the nail plate. If, after two weeks, the dark spot has not disappeared, you should immediately consult a doctor.

The best treatment for a disease is prevention. Timely seeking medical attention is essential. Stage 1-2 melanoma is treatable even in case of relapse.

Subungual melanoma is difficult to treat but can be easily prevented. For this, a number of preventive measures should be taken.

Preventive methods are very important, as it is often easier to prevent an illness than to cure it. What can be done so that the disease does not appear? Especially this issue should be taken care of by people at risk:

To prevent malignant degeneration of moles and nevi, doctors recommend timely surgical intervention in case of acute trauma to the pigment spot. Also, moles are subject to excision, the localization of which contributes to their increased trauma.

In addition, people of all ages are not recommended to be exposed to ultraviolet rays for a long time, as well as to be exposed to numerous sunburns.

It is extremely important to remember that only early diagnosis and complex therapy can ensure a complete recovery.

megan92 2 weeks ago

Tell me, who is how to deal with joint pain? My knees hurt terribly ((I drink painkillers, but I understand that I am fighting the investigation, not the cause ... Nifiga does not help!

Daria 2 weeks ago

For several years I fought with my aching joints until I read this article by some Chinese doctor. And I have long forgotten about the "incurable" joints. Such is the case

megan92 12 days ago

Daria 12 days ago

megan92, so I wrote in my first comment) Well, I'll duplicate it, it's not difficult for me, catch it - link to professor's article.

Sonya 10 days ago

Isn't this a divorce? Why are the Internet selling ah?

yulek26 10 days ago

Sonya, what country do you live in? .. They sell it on the Internet, because shops and pharmacies charge a brutal markup. In addition, payment only after receipt, that is, first looked, checked and only then paid. And now everything is sold on the Internet - from clothes to TVs, furniture and cars.

Editorial response 10 days ago

Sonia, hello. This drug for the treatment of joints is really not sold through the pharmacy chain in order to avoid overpriced. Today you can order only on Official site... Be healthy!

Sonya 10 days ago

I apologize, I didn't notice the information about cash on delivery at first. Then, it's OK! Everything is in order - exactly if the payment is on receipt. Thank you so much!!))

Margo 8 days ago

Has anyone tried alternative methods of treating joints? Grandma does not trust pills, the poor one has been suffering from pain for many years ...

Andrey 1 week ago

What folk remedies have I tried, nothing helped, it only got worse ...

Ekaterina 1 week ago

I tried to drink a decoction of bay leaves, no use, just ruined my stomach !! I no longer believe in these folk methods - complete nonsense !!

Maria 5 days ago

Recently I watched a program on the first channel, there is also about this Federal program for the fight against joint diseases spoke. It is also headed by some famous Chinese professor. They say that they have found a way to permanently cure joints and back, and the state fully funds the treatment for each patient

Melanoma under the nail can appear in a person of any race, regardless of place of residence, age and social status. The risk group for the development of the disease includes:

• people with fair skin and blue eyes, freckles and red hair;
• persons who have had sunburn in the past;
• relatives of family members who have been diagnosed with cases of subungual melanoma;
• older men over 60;
• people who are fond of sunbathing and tanning, including in artificial conditions - solariums;
• persons with immunodeficiency, vitamin deficiency, work in hazardous work, etc.

Symptoms (early stage and late)

In order not to start the disease, it is important to accurately represent the signs of the initial stage, indicating the development of oncology. The very first of them are:

• the appearance of a small dark spot or streak under the nail;
• there is no healing of the plate, as with bruises;
• the appearance of the nail undergoes changes - the surface becomes uneven, sometimes cracks appear.

With the progression of melanoma, it will be easier to identify it according to the following signs:

• the stain becomes saturated, dark, up to black, color, does not lighten over time;
• the defect has uneven edges and grows rapidly in just a few months and even weeks;
• with an accumulation of pus, the bed rises, it is possible to dissect it along the axis;
• when the malignant process spreads, the nail and the skin around it become covered with nodules and ulcers.

Sometimes nail melanoma occurs without any symptoms. This is a non-pigmented neoplasm, despite the degeneration of melanocytes. In this case, the tumor will look like a dense knot that raises the edge of the nail plate.

Pain in melanoma often occurs already at the second stage of the oncological process, but it may be absent up to the terminal, until the nail cancer grows into the bony structures of the finger.

Types, types, forms

There is a specific classification of nail melanoma. Consider it.

Types of tumor localization:

• the neoplasm affects the nail matrix;
• the malignant process is located under the plate;
• oncology is located in the periungual zone of the finger, in the skin.

All of these types of melanoma are life-threatening. The disease leads in mortality among other cancerous lesions of the epidermis.

• Superficial melanoma. The most common type of pathology is about 70% of all cases. Melanocytes are subject to atypical changes in the outer layers of the skin and nails. The disease begins with the appearance of an inconspicuous dark spot, which quickly grows and grows into the deep structural layers of the dermis. Prevalent among the European race.
• Lentigo. It has a lot in common with superficial melanoma, since its development originates in the outer layers of the skin and nail. Outwardly, the pathology is manifested by the rise of the affected area and its uneven staining in a dark color - pigmentation. It occurs in 10% of cases.
• Acral melanoma. The rarest tumor. It affects the surface of the dermis or nail, but quickly grows into their deep layers. Has the appearance of a black spot. It is mainly found in individuals with dark skin color. Europeans are rarely diagnosed.
• Nodular melanoma. From the initial stage of the disease, the tumor grows deep into the dermis. Because of this, it often goes unnoticed, because the surface layer of the nail is not changed and does not differ from healthy tissues. It is considered the most aggressive. It accounts for 12-15% of morbidity cases.
• Melanoma of the nail plate of the thumb. The favorite place of pathology is the big toe, in second place is the little toe. This is due to the fact that these fingers are more often exposed to traumatic factors, for example, when wearing tight shoes.

The stages, types and symptoms of the disease are fully consistent with the above classification. Despite the fact that subungual melanoma of the thumb can be noticed by a person early, often the pathological process when visiting a doctor turns out to be neglected, since many perceive it as an injury or a fungal infection.

Diagnostics

Faced with a suspicion of nail cancer, the patient is sent for a comprehensive examination. And first of all, he is assigned a test for tumor markers. The procedure is performed using a dermatoscope, which shines through the stratum corneum and nail plate, and the specialist draws conclusions about the malignancy of the process in them.

After testing for tumor markers, a biopsy is recommended. A partial sampling of the neoplasm tissue is made from the patient and the material is sent to the laboratory. There, a histological examination is carried out, which gives the final verdict in the diagnosis.

Having determined the nature of the patient's disease, the doctor prescribes appropriate treatment for him.

The success of early diagnosis largely depends on the qualifications and experience of the specialist. He must accurately determine what problem the person has addressed, whether it is a hematoma after a bruise on the finger or subungual malignant melanoma.

Treatment

The disease is amenable to therapeutic methods in the early stages of the oncological process. The tumor is excised, simultaneously capturing the nearby healthy areas - tissue of subcutaneous fat and muscles.

If melanoma has grown and is found in the deep layers of the matrix and dermis, amputation of the nail or phalanx of the finger is often required. The whole process takes place under general anesthesia, so during the operation the patient will not feel anything.

If the lymph nodes are affected, they are also subjected to control resection. Additionally, chemotherapy and radiation therapy is prescribed, aimed at destroying the atypical cells remaining in the body. These procedures are debilitating for anyone, but they greatly increase the effectiveness of the treatment.

After the diagnosis is made, the doctor can offer the patient the following ways to deal with melanoma:

• Phalanx exarticulation. During the intervention, the surgeon removes the affected tissue of the nail fold along with the plate. The rehabilitation of the focus is so deep that some patients are partially removed from the nerve endings.
• Amputation of the distal phalanx. If the tumor intensively spreads metastases to the bone structure of the finger, then removal is considered the only correct option for treating the patient. In this case, there are good chances to save the limb and prevent the spread of cancer cells through the bloodstream.
• Chemotherapy. After removing the nail plate or phalanx of the finger, a diagnosis is required to determine the secondary cancer foci. If metastases are found, an intensive course of chemotherapy is prescribed. These are medications, usually taken orally, less often intravenously. They destroy atypical cells in the body, but they also destructively affect healthy tissues. The kidneys, liver, blood and lymph are most affected by them. Against this background, the patient has many side effects, such as deterioration of the immune defense, weight loss, weakness, etc.
• Cytostatic course. Drugs of this type are used in parallel with chemotherapy. They target the foci of metastatic changes and prevent atypical cells from clinging to the body. Cytostatics are good because they interact exclusively with malignant elements and do not affect the human body in a negative way.

Alternative treatment in the fight against melanoma is not recommended, only if it is not prescribed by a doctor. Homemade recipes based on medicinal herbs and animal components may have some power against cancer, but their effectiveness has not been proven and cannot be used in the treatment of such serious diagnoses.

Recovery process after treatment

During the rehabilitation period, all patients should be under the supervision of medical personnel. At the first postoperative stage, symptomatic treatment is prescribed, which includes general strengthening, immunomodulatory and analgesic drugs.

Many patients experience the fact of removing the nail plate. Nowadays, the wound surface is closed with an artificial valve. At the same time, there is no need to worry, the new nail will grow rather quickly - after 6, maximum 12 months.

After removing the phalanx of the finger on the hands or feet, the patient may need the help of a psychologist.

After discharge from the hospital, patients should register with an oncologist at their place of residence and regularly visit a doctor in order to avoid relapses of melanoma.

Diet

Loss of appetite is one of the problems of people suffering from cancer. Deficiency of trace elements and nutrients seriously weakens the body's defenses, interfering with its fight against cancer cells. Therefore, the following components must be present in the diet of a person suffering from melanoma:

• Fiber: positively affects the condition of the digestive system, absorbs toxic compounds.
• Lycopene: inhibits the division of atypical cells, prevents the risk of metastases.
• Polyphenols: have anti-cancer effects.
• Ascorbic acid: regenerates tissue and normalizes immunity.
• Vitamin E: reduces the number of atypical elements in the body.
• Vitamin D: enhances the skin's protection against UV radiation.

The listed components should enter the body mainly with food, and not with medicines and artificial multivitamin complexes.

The diet of a person with nail melanoma before and after surgery should consist of the following dishes:

• fruits, vegetables, herbs in any form and volume;
• cereals, nuts and sprouted seeds;
• green tea or herbal tea;
• oily sea fish;
• protein diet food - turkey, chicken, rabbit;
• whole grain cereals;
• fermented milk products;
• drinking water at least 2 liters per day.

The diet should be fractional - you need to eat 5-6 times a day in small portions. Food should be baked or steamed. It is advisable to eat fruits and vegetables raw, as in this case they contain more vitamins.

It is important to completely abandon canned, fatty and fried foods, forget about confectionery, fast food and alcoholic beverages. You need to limit the amount of animal fats in your diet as much as possible, including offal.

In general, nutrition for nail melanoma should harmoniously complement the therapeutic and rehabilitation course prescribed by the oncologist.

The course and treatment of the disease in children, pregnant and lactating women, the elderly

Children. Among the malignant diseases that occur in childhood, melanoma accounts for about 1%. However, in recent years, doctors have noted an increase in the number of diagnoses of this pathology. Usually, melanoma in a child develops due to unfavorable heredity, adolescents are most susceptible to it due to changes in hormonal levels during puberty. Less commonly, an infant is born with a congenital tumor that has arisen during the period of intrauterine development. Treatment depends on the stage of the malignant process. At the initial stage, the neoplasm is excised electrosurgically with the surrounding healthy tissues, followed by a rehabilitation period and supervision by a specialist. In the later stages, in addition to surgery, cryosurgery, immunotherapy, chemotherapy and body irradiation are used. According to statistics, 50% of children do not live for 5 years after surgery for nail melanoma.

Pregnancy and lactation. Pregnancy changes the hormonal background of a woman, which can provoke the activity of melanocytes and cause their atypical growth. Trauma to nails and birthmarks during the period of bearing a child should be completely excluded. Detection of subungual melanoma in a pregnant woman requires immediate intervention. At the first and second stages of the malignant process, a woman is prescribed surgical removal of the tumor, sometimes with the need for a preliminary cesarean section (if the time allows). At the third stage, specialists recommend an artificial abortion, since the disease cannot be cured without chemotherapy and radiation, which have a teratogenic effect on the fetus. In any case, a woman has the right to decide on her own to terminate a pregnancy. The prognosis for recovery in patients in the position is worse than in the rest.

Advanced age. In older people, melanomas, including those of the nail, are most common. This is due to the age factor, concomitant diseases, and reduced immunity. Due to their attitude to their own health, persons over 60 rarely see a doctor in the early stages of subungual melanoma, perceiving its development as a cosmetic defect. Treatment and prognosis in this case do not differ from other situations - the earlier the disease is detected, the higher the chances of coping with it.

Treatment of nail melanoma in Russia, Israel and Germany

Melanoma is treated on condition of timely contact with a medical facility. Therefore, early detection of the tumor is important. We invite you to find out how they fight this disease in different countries.

Treatment in Russia

In our country, however, as in the whole world, a high mortality rate from melanoma has been recorded. Therefore, much attention is paid to the therapy of this malignant disease. There is even a Melanoma Day, which is traditionally held in the last ten days of May - during which anyone can contact the cancer center and be examined free of charge for neoplasms on the skin and nails.

In addition to surgical treatment, this tumor is eliminated with the help of polychemotherapy, biologically active additives, immunological action "Interferon" and radiation. In all regions of Russia there are many clinics with a decent level of service and the latest equipment, where good results are noted. Most of them are concentrated in Moscow and St. Petersburg:

• FSBI "Russian Oncological Center named after N. N. Blokhin", Moscow.
• International Clinic Medem, St. Petersburg.

How much will diagnostics and treatment cost in the listed medical centers? Consider the approximate prices:

• consultation with an oncologist - 5400 rubles;
• second opinion of a specialist from partner clinics in Israel or the United States - from 20 thousand rubles;
• diagnostics of melanoma using FotoFinder - 5 thousand rubles;
• selection of chemotherapy - 3800 rubles.

The cost of treatment will vary depending on the area of \u200b\u200bsurgery and the need for additional therapeutic procedures.

Consider reviews of the listed clinics.

Mikhail, 45 years old. “I applied with a suspicion of toenail melanoma to the Medem International Center. After examination, they took tests, the diagnosis was confirmed, the degree of cancer is first. Then they had an operation, I continue to be monitored by the oncologist, everything is fine. "

Svetlana, 36 years old. “I covered the dark spot on the nail with a manicure for a long time, considering it a cosmetic defect, and did not think about oncology. As a result, I delayed seeing a doctor. In the Moscow Blokhin Center, there was practically no hope for a positive prognosis. After the operation, there were courses of chemotherapy and radiation. Two-year remission has been achieved. "

Treatment in Germany

In this country, the fight against melanoma has reached a qualitatively different level. The attitude to this pathology as an incurable type of cancer has changed here - the results of therapy are positive in 95-100% of cases.

The main option for the treatment of melanoma remains its surgical removal, but a fundamentally different approach is used for this intervention. In the process of tumor resection, computer technologies are used, which makes it possible to perform excision in the most efficient way. If necessary, plastic is done to eliminate external defects of the nail.

In addition to the operation, immunotherapy is necessarily prescribed, which prevents metastases and postpones tumor recurrence. This approach increases the percentage of individuals passing the 5-year survival rate.

In a complex effect, chemotherapy is also prescribed. Doctors try to use the most effective and gentle drugs for the human body.

Also in German clinics such innovative technologies are actively used as:

• gene therapy;
• vaccine therapy;
• adaptive immune therapy.

All of them, in their own way, fight against the malignant process in the body, increasing the patient's chances of recovery.

The average duration of diagnosis in Germany is 3-5 days, the course of melanoma treatment is from 7 to 15 days, at least 1 month. We offer you to find out the cost of the services provided (prices are indicated in euro currency):

• diagnostics (full range) - from 3 thousand;
• removal of melanoma - 15 thousand;
• chemotherapy - 3-5 thousand;
• immunotherapy - 5 thousand;
• radiation therapy - 10-15 thousand

Where can you go in Germany with nail melanoma?

• Freiburg University Hospital.
• Clinic network MedHaus, Berlin.

Consider reviews of the listed medical institutions.

Julia, 47 years old. “I chose not to risk it and took my mother with nail melanoma to the Onco Union medical center, also called the German Union of Oncologists. The results are positive. I definitely recommend it. "

Olga, 45 years old. “My sister underwent surgery for nail melanoma at the University Hospital Freiburg. The prognosis for remission is not bad. The doctors are wonderful. "

Treatment of nail melanoma in Israel

In this country, melanoma therapy is carried out most successfully. Treatment is selected taking into account the age characteristics of the patient, the stage of the malignant process and other factors.

Let's talk in more detail about the clinics where the fight against skin and nail melanomas is carried out.

• Ella Melanoma Institute. An institution that deals with the diagnosis and treatment of dermal cancer. They successfully fight melanomas of any stage, even metastases. The therapy is carried out using the TIL technique. It is based on the activation of anti-cancer lymphocytes.
• Assuta Medical Center. Provides assistance in melanoma therapy. It is carried out at all stages of the malignant process. An innovation is the use of the drug "Selboraf". Hundreds of surgeries were performed with a positive outcome.
• Clinic "Ichilov". The institution practices the use of innovative methods of treating melanoma, which have no analogues in the world. Completely new therapies are being developed, such as Adoptive Immunotherapy. Despite the fact that the technique is still at the development stage, the results from its application are successful and are of interest to many medical institutions.

Consider the approximate cost of diagnostics and treatment of nail melanoma in Israel:

• oncologist consultation - $ 600;
• biopsy histology - $ 1400;
• surgery with 2 days of hospitalization - $ 7500;
• chemotherapy course - $ 1250;
• immunotherapy and targeted treatment - $ 3000.

We invite you to find out reviews about the listed medical institutions in Israel.

Inna, 36 years old. "Thanks to the doctors of the Ichilov clinic for the successful operation for nail melanoma."

Maria, 56 years old. “At the Assuta Medical Center, I had a tumor of my big toe removed. The treatment was carried out without unnecessary delays, everything was as fast and accurate as possible ”.

Fighting nail melanoma in Israel allows you to get rid of the disease or achieve remission. In this country, a high level of cancer care is provided by qualified doctors and the latest treatment technologies.

Complications and relapses

In the early stages of the oncological process, the prognosis is favorable. If melanoma has gone deep into the nail plate and its subcutaneous layers, the likelihood of tumor recurrence exists even if it is removed.

The highest percentage of metastasis and secondary cancers is at the 3rd stage, when the size of the carcinoma is more than 4 mm. At the last stage of the pathology, the malignant process is practically not subject to treatment.

In the case of a successful outcome and recovery of the patient (usually this happens at the first, less often at the second stage of the oncological process), it is important in the future to be attentive to your own health. A person should regularly self-examine the condition of the nail plates. Relapse of melanoma can develop even after many years. If you find suspicious symptoms - dark spots on the finger or deformity of the nail - it is important to seek the advice of a doctor as soon as possible.

Forecast at different stages

Presumptive predictions of how the disease will end depend on the stage of melanoma under the nails. If the pathological process is detected early, there are enough chances to cure the tumor. At the same time, deep ingrowth and spread of a malignant neoplasm throughout the body has a disappointing prognosis for a person's recovery.

Consider in the table the 5-year survival rate for subungual melanoma.

Prevention

Cancer of the nails of the fingers or toes is difficult to treat in advanced stages of the oncological process. Therefore, doctors insist on observing the following preventive measures to prevent the development of a malignant process:

• During the warm season, mainly in spring and summer, it is important not to be in direct sunlight between 10 am and 4 pm. This rule especially applies to persons with light hair and skin type, freckles.
• In case of serious injuries to the nail plates, it is important to consult a specialist - sometimes these problems can provoke the development of a malignant process, so you should not eliminate them yourself.
• To systematically examine the nails for external changes - for any warning signs, you need to see a dermatologist.
• Monitor hormonal levels and strengthen the immune system.
• Eliminate bad habits and visit the solarium.

Melanoma affecting nail tissue does not always end in death. With a timely visit to a doctor, you can not only cure the disease, but also avoid its recurrence. The main thing is to trust a specialist in everything.

Are you interested in modern treatment in Israel?

Melanoblastoma is an outdated name for a malignant tumor. The neoplasm is a type of skin cancer and is a dark brown spot.

The process begins with the defeat of melanocytes - skin particles responsible for pigmentation. Only one cell can serve as a focus of the disease.

From a benign state, the tumor becomes malignant. If the pathology is not stopped in time, the probability of the spread of the disease to the rest of the body is high.

Statistics indicate the leading positions of skin cancer. The peculiarity lies in the rapid growth of metastases and the appearance of complications leading to increased mortality.

The disease appears for the following reasons:

• Under the influence of ultraviolet radiation, when a person is in direct sunlight for a long time, melanin is produced at this moment.
• Various injuries, burns, poor environmental situation provoke the appearance of the disease.
• No less important is the genetic factor due to the presence of similar diseases in the family. The risk of disease increases by 50%.
• The period of menopause and pregnancy can be dangerous, as it triggers the degeneration of moles into melanoma.
• During leg depilation, foot cleaning, attention is paid to neoplasms so as not to damage the skin.
• Weak immunity provokes the formation of melanomas on the legs. Surgical interventions, transplantations, chemotherapy lead to a decrease in immunity and the development of pathology.

Melanoma under the nail is a malignant oncological tumor, subtle and very insidious, capable of quickly spreading cancer cells throughout the body (metastasizing). It is formed from melanocytes - special cells that affect the pigmentation of the skin and other integuments of the human body.

A malignant tumor forms under the nail plate on the big toes, less often the hands (very rarely, other fingers are affected, for example, the little finger on the fingernail), it can also be on the skin, but does not affect the palms and feet.

Elderly people (from 50 to 80 years old) are sick more often than others, but now the disease "has become younger" and has begun to affect young people, and sometimes even children. Features of melanoma of the nail plate of the big toe or hand are:

• asymptomatic in the first stages;
• accelerated progression and growth (from the initial stage to the last one can pass in a few months);
• active metastasis;
• problematic diagnosis (difficult to distinguish from injuries and other diseases).

Most susceptible to developing cancer on the big toe or upper limb:

• people with fair skin by nature;
• fair-haired, especially red-haired;
• people with many age spots and moles on the body.

The neoplasm can be localized not only under the nail, but also on the skin next to it. Visually, it looks like a darkish (almost black) spot with indistinct edges and an asymmetric shape.

Its color can vary from brownish to reddish-black; tumors can also be observed in shades of brown, pink, purple and even colorless (in 15% of cases).

This is the name of the malignant degeneration of pigment cells - melanocytes. It is known that the disease can affect the skin. However, there are cases when abnormal cells can form under the nail.

The disease is quite rare. It occurs somewhat more often in men than in women. The growth of such a tumor occurs much faster than other malignant neoplasms, which explains the high mortality rate from this disease. Melanoma of the nail has several varieties:

1. A tumor that grows out of the nail matrix.
2. Melanoma that forms under the nail plate.
3. A tumor that grows on the skin next to the nail plate.

Reasons for the appearance

Previously, melanoma under the nail was found only in people of retirement age, however, recently it has been increasingly diagnosed in people of young and mature age. A sign indicating the development of cancer is darkening of the nail (most often signs are observed on the thumbnail), after which a tumor begins to appear that destroys the nail.

Melanoma can be caused by:

• Severe trauma to the nail, untimely treatment of the wounded area with antiseptic agents.
• As a result of sunburn.
• Due to a person's natural predisposition to disease. The risk group includes several categories of people: redheads with freckles. People of any skin color and ethnicity have the same risk of developing melanoma.

The main reason for the development of melanoma is the degeneration of melanocytes into malignant cells. This process is triggered by a genetic mutation that allows cells to divide without restrictions. As a result, melanoma on the foot grows, and in the last stages begins to metastasize.

This process can be influenced by one of the provoking factors or their combination:

• Exposure of the skin to solar ultraviolet radiation in a certain range - UV-B (280-315 nm). Artificial UV radiation also increases the risk of melanoma formation.
• Belonging to a particular genotype and phenotype. The lowest risk of developing a tumor on the leg is in Africans and Asians, the highest is in Scandinavians, whose skin has a low tolerance to solar radiation.
• Immune status. Immunodeficiency states can accelerate the development of skin malignancy.
• Injury to a large mole can lead to its degeneration into a malignant tumor.
• Changes in hormonal levels during pregnancy (treatment prognosis is better) or in menopause (worse prognosis) increase the risk of development.
• Hereditary predisposition.
• The presence of nonspecific nevi on the body.

Any neoplasm has a cause affecting its activation. The target is the nail. The basis for the origin is considered:

• living in a bad ecological climate;
• the use of modified, low-quality products;
• relationship with harmful carcinogenic substances;
• bad habits (often cheap alcoholic drinks, tobacco);
• nail injuries;
• signs of one of the risk groups.

Absolutely everyone can get nail oncology, regardless of age, skin color, race and other characteristics.

In terms of growth rate, this pathology is only ahead of lung cancer. Previously, it was peculiar to manifest itself in elderly patients, but nowadays it is seen in young people more often in comparison with previous generations.

Among oncological diseases, subungual melanoma accounts for 3% of cases in women and 4% in men, and even though science is not able to say the reliable reasons for the development.

Etiology and types

Melanoma is an atypical degeneration of melanocytes or pigment cells. The disease affects the human dermis, but, in rare cases, abnormal cells can appear under the nails.

The disease is considered rare; men suffer from it more often than women. Subungual melanoma is characterized by rapid growth and high mortality.

Melanoma of the nail is divided into several types and categories.

Types of disease:

• formation that affects the nail matrix;
• a tumor localized under the nail plate;
• melanoma on the skin, next to the nail plate.

All of these species pose a danger to human life. In terms of the number of deaths, the disease is the leader among skin cancers.

• the nail plate quickly changes color;
• the nail is undergoing changes;
• when pressing on the plate, pain appears;
• a crack appears along the nail.

Depending on the localization of the malignant process, the following cancers of the nails are distinguished:

1. Melanoma of the nail plate.
2. Subungual melanoma, actually.
3. Melonoma, the development of which occurs from adjacent tissues.

Longitudinal melanonychia develops from a strip on the nail plate. Occurs in representatives of the dark-skinned race. Most often these are African Americans (over 75%), Japanese (about 15%). Other peoples with dark skin. White Europeans hardly get sick with this type of melanoma (1%).

Outwardly, melanonychia is a pigmented strip located longitudinally along the nail plate. More than one nail may be damaged. Development is due to the high melanin level in the plate. It is found by examining the profile of the distal nail edge.

Often, longitudinal melanonychia occurs after a chronic injury to the big toe. A benign tumor is not required. If it becomes cancerous, amputation of the toe joint is recommended.

Acral melanoma - forms on the nail bed. It is distinguished by a black color similar to the effects of a bruise.

The neoplasm is not palpable until the size of a malignant vertical tumor is acquired. Soreness, increased pigment, longitudinal splitting of the nail plate, changes in shade - reflect the stage of the disease.

Melanoma of the leg can be a consequence of a nail tumor. The opposite effect occurs when a rapidly growing neoplasm on the leg, emerging from an old mole, sends cancerous tentacles into other organs.

Additional symptoms with this ailment are severe itching, inflammation along the edge of the pigment spot, bleeding of the tumor. It is worth repeating once again that only the earliest diagnosis and the beginning of treatment can save you from death.

Melanoma of the foot is often found on the big toes, which is determined by histological examination of tissues taken for a sample from a patient. Nodular formations that rise above the level of the skin are considered aggressively developing.

Etiology and types

Melanoma is a malignant skin formation that forms as a result of damage to the cells responsible for pigmentation - melanocytes. Earlier in the medical literature, this form of cancer was called melanoblastoma.

In more than 50% of cases, it forms on the lower extremities. Melanoma often forms on the foot, as well as on the toes, on the lower leg and higher in the knee area.

Types of tumor of the nail plate

Development stages

1. At the first stage, the area is affected no more than 2 mm, the formation is localized on the surface of the skin, there are no depressions and metastases. The risk of re-development is low.
2. At the second stage, the thickness of the formation reaches a size of over 2 mm, ingrowth into soft tissues begins, without the formation of metastases.
3. In the third stage, the lymph nodes are affected. Exit outside the primary focus is characterized by the third stage, which is confirmed by a biopsy of the nearest lymph node to the diseased area.
4. At the fourth stage, metastasis in tissues, damage to bones and internal organs develops. The prognosis of cure is low and hovers around 10%.

The diagnostic criteria are the thickness of the neoplasm, called Breslow thickness, the rate of division of cancer cells, and microscopic manifestations. The combination of all the criteria allows you to determine the degree of damage and plan effective treatment. The thinner the thickness of the Breslow, the more likely it is to be cured.

There are four stages of malignant melanoma. On each of them, the tumor behaves in a different way and manifests itself with different severity.

The spread of skin cancer in the leg can be very rapid. For this reason, early diagnosis is of fundamental importance: the effectiveness of treatment directly depends on this.

It is important to have a clear idea of \u200b\u200bwhat melanoma looks like, and if you suspect its formation, immediately consult a doctor. Outwardly, melanoma looks like a seal that protrudes slightly above the surface of the skin. However, if we are talking about malignant lentigo and acral-lentiginous form, then the edges are somewhat blurred.

In the zone of localization of pathology, metastases are actively spreading. This is especially true for oncopathology located on the toe. The malignant formation is rapidly increasing in size. If the nail plate of the toe is deformed and cracked, the affected surface may bleed.

The development of a tumor on the foot proceeds more actively and with even worse consequences. The oncological process affects the skin of the leg, and with progression it can lead to the formation of metastases in the internal organs.

When making a forecast, the identification of the stages of oncopathology plays a key role. The development of all forms of melanomas, with the exception of nodular, starts from the stage of radial growth. At this phase, the tumor on the leg grows in size very slowly, has an asymmetric shape along the axes, ragged edges or consists of small isolated islands.

The pigment spot in color varies from light sandy to deep brown. If a large amount of melanin accumulates in the skin, the color of the tumor is sometimes blue.

Small size non-pigmented melanomas occur. They look like pale pink knots on the surface of the skin. It is easy to confuse them with a mole or a small birthmark, but they are some of the most dangerous because of the aggressive course. You should undergo an examination as soon as possible if such a formation begins to itch and become covered with ulcerations.

Signs of the degeneration of such a mole or spot are a change in the configuration of the formation, color and an increase in area. A malignant tumor on the leg is very rarely less than 6 mm in diameter, more often more than 10 mm.

The second stage of development is vertical growth. Within the boundaries reached at the stage of radial growth, tumor nodes begin to form. On the surface of melanoma on the skin of the leg, single or multiple ulcerations may appear. The main distinguishing feature of this stage in the diagnostic process is the presence of dermal tumor nests (nodules).

At the third stage, the tumor on the leg grows and leaves the boundaries of the initially formed focus. Depending on its location, nearby lymph nodes may be involved in the oncological process.

At the fourth stage, the tumor gives multiple metastases. The oncological process, in addition to the skin, covers deeper tissues, including bones.

Melanoma under the nail develops gradually. At first, this disease may be completely invisible or "disguised" as another problem. Often, patients go to the doctor when it is too late - at the third or fourth stage of the disease. There are four stages of cancer development.

The presence of moles and age spots requires a person to regularly monitor their condition. If abnormal changes in the structure of the nevus are found, it is necessary to immediately consult an oncologist.

In oncological practice, two main methods of therapy are used to treat melanoma in the early stages:

1. A surgical procedure that removes all cancerous tissue.
2. A complex technique that includes surgery and radiation therapy. The combination of surgical excision of the tumor and radiological technique gives the most favorable results and the chances of cancer survival... Radiation exposure through the use of highly active X-ray radiation allows the destruction of possible cancer cells in the lymph nodes.

The following symptoms indicate tumor metastasis:

• the appearance of a tangible seal under the nail plate;
• the presence of a chronic cough;
• change in skin tone (it becomes dull, ashy);
• the patient's body temperature rises;
• the nail is almost completely destroyed and bleeds;
• seizures develop;
• lymph nodes are enlarged and thickened;
• weight loss (sometimes even to cachexia).

What is melanoma and how to detect it yourself (video)

How the disease progresses

Subungual melanoma has its own specific features by which it can be distinguished from other pathologies. As the disease progresses, symptoms begin to change, and a minor defect becomes a visible neoplasm.

• a small pigmented spot or strip under the nail plate;
• the defect does not go away, unlike a hematoma after two weeks;
• the age spot increases in size;
• a color change occurs up to black or dark brown;
• the edges of the defect begin to bend;
• education moves to the nail roller;
• cracks, bleeding wounds, nodules appear on the roller;
• the nail plate is deformed.

Important! Subungual melanoma does not always change color. The disease can develop for a long time, without any symptoms. There are cases when nail melanoma spread to the sole.

In the initial stages, this pathology is very insidious. This is due to the fact that the disease can be confused with the usual hematoma or nail felon.

The tumor growth rate changes frequently. With slow development, metastasis occurs at the last stage of the pathology, and with rapid progression, metastases are spread by blood to distant organs.

The process of metastasis can be determined by the following signs:

• a noticeable seal under the nail;
• chronic cough;
• skin color becomes gray, dull;
• high body temperature;
• the nail collapses and begins to bleed;
• convulsions appear;
• lymph nodes increase;
• the patient's weight is sharply reduced.

Most often, this disease is found in the area of \u200b\u200bthe big toe or toes - it is usually deployed not on the nail, but on the skin under or next to it. Gradually, the disease develops, spreading throughout the nail plate. You need to sound the alarm in the following cases:

• a dark spot grows on the nail plate (it darkens completely in a month or two);
• painful sensations appear when pressed;
• hematoma under the nail does not go away within 14 days;
• bleeding in the nail area, the appearance of pus;
• color: red, purple, brown and up to purple and black;
• sores under the nails.

The primary manifestations of subungual melanoma are virtually absent, and only during the development of a cancerous lesion is the external manifestations of the tumor detected in the form of:

• The presence of a small brown spot that is located at the base of the nail bed. In some cases, the nail lesion may develop as a longitudinal strip on the nail. From time to time, before the origin of external manifestations, patients note a finger injury, for which timely medical care did not appear.
• In the later stages of the disease, the age spots increase in size and the color becomes much more intense.
• During growth, a malignant neoplasm spreads to the entire nail plate and adjacent soft tissues.
• The terminal stages of the disease are accompanied by the formation of a nodular lesion of the nail tissue, followed by ulceration and the origin of spontaneous bleeding.

Melanoma on the nails has its own characteristics that distinguish it from other diseases. Symptoms may change with the development of the disease. A nondescript defect becomes a noticeable tumor. Specific changes and signs:

• first, a small pigment spot or a strip on the nail plate appears under the nail;
• the defect does not go away after 2 weeks, like a hematoma after a bruise;
• there is a gradual increase in pigment;
• color changes, turning into dark brown, black;
• edges become uneven;
• the damage goes to the nail roller;
• cracks, nodules, wounds with bleeding are formed;
• deformed, curving and thickening, the nail plate.

Subungual melanoma does not always darken. The disease develops for a long time without suspicion of its seriousness. With changes in the area of \u200b\u200bthe nails, you should observe their course. Symptoms become apparent at stage III, when metastases are already developing.

Considering the rate of development and growth of this malignant skin lesion, early detection of the tumor is very important for successful treatment. Accurate diagnosis is difficult because melanoma is easily confused with a common nail injury.

At the initial stage, this malignant formation is often mistaken for a hematoma after injury, paronychia (suppuration) or panaritium (inflammation of the periungual ridge).

Most often, melanoma is found on the large nails of the hands or feet. A swelling on the toenail is more dangerous. The neoplasm does not develop on the nail plate, but under it or next to it in the skin.

While developing, it spreads to the entire nail plate. The main symptoms of melanoma are as follows:

• a dark spot appears on the nail, gradually increasing in size;
• the appearance of the spot may be preceded by trauma (if there is a hematoma under the nail, then it will pass within 2 weeks, if it does not go away, then you need to contact the oncology department);
• in a few months, the spot under the plate can completely cover it;
• when feeling the nail, painful sensations and bleeding are possible;
• tumor color - black, purple, brown heterogeneous, dark purple, red;
• ulcers appear under the nail, undermining it;
• purulent discharge is possible.

Acral nail melanoma deserves special attention. This species develops on the nail bed. The main symptom of an acral tumor is a black longitudinal line on the nail, as in the photo.

The disease is often confused with a bruise, which is why they do not seek medical help on time. It is impossible to feel the tumor until it passes into the malignant stage of vertical growth. The symptoms of such melanoma can be described as follows:

• degeneration of the nail plate;
• color change;
• painful sensations;
• the growth of a pigmented defect;
• longitudinal splitting of the plate.

The nail tumor changes its behavior depending on the stage of development:

1. At the first stage, its thickness does not exceed 1 mm, it is not palpable and does not bother.
2. On the second, the thickness increases to 2 mm or more, the tumor changes color and spreads along the nail.
3. On the third, cancer cells are separated from the primary focus, after which they spread to the nearest lymph nodes (cancer begins to metastasize).
4. On the fourth, metastases appear in vital internal organs.

Based on the above, it can be concluded that nail melanoma is easiest to treat at the initial stages of its development. But first you need to diagnose it.

To do this, the patient must contact an oncologist, who will prescribe a number of tests, such as a visual examination, a blood test, and a histological examination. If a malignant tumor is detected, additional studies are prescribed in the form of ultrasound of internal organs and tomography.

At the first stages, it is very difficult to notice the tumor. Signs of the disease may change during development. The main symptoms of nail melanoma include:

• the appearance of a small dark pigmented formation under the nail plate;
• sometimes, instead of a spot, a thin vertical stripe of dark brown color is formed;
• the defect does not disappear after 10 days, as with a conventional hematoma;
• the size of the spot begins to grow rapidly;
• the neoplasm has fuzzy boundaries;
• over time, the tumor passes to the lateral edges of the nail plate;
• peeling, cracks appear, from which blood and ichor are released;
• the surface of the nail is deformed, becomes bumpy.

In about 20% of cases, this disease has no pigment. Because of this, it is not possible to recognize melanoma in the initial stages.

The first symptoms in such cases appear only at the third stage, when the spread of metastases along the internal organs and bones of the skeleton already begins. The rate of development of this disease is very fast, sometimes the transition from the first to the third stage takes only a few months.

It is formed from melanocytes, the cells responsible for the pigmentation of the human skin. Most often, this disease occurs on open areas of the skin - the face or body, but sometimes the formation appears on the mucous membrane of the nasopharynx, in or in the nail plates of the fingers.

Subungual melanoma is rare and accounts for about 4% of the total melanoma. Diagnosis of subungual melanoma in the early stages of tumor development is difficult due to the atypical symptoms when it appears, and at later stages it is characterized by accelerated metastasis, as a result of which this disease poses a serious threat to health and life in general.

Reasons for the appearance

There are practically no definite reasons why this skin lesion occurs, but quite often subungual melanoma develops after an injury to the nail plate or in the area of \u200b\u200bthe nail. Doctors distinguish several groups of people who develop this type of melanoma more often:

• belonging to a particular genotype - light or red hair, blue eyes, the presence of freckles on the skin;
• hereditary predisposition - the presence of relatives with melanoma of any type;
• advanced age - over 50;
• excessive exposure to ultraviolet light - abuse of sunbathing and visiting a solarium, a history of sunburn.

Symptoms of subungual melanoma

Considering the rate of development and growth of this malignant skin lesion, early detection of the tumor is very important for successful treatment. Accurate diagnosis is complicated by the fact that.

At the initial stage, this malignant formation is often mistaken for a hematoma after injury, paronychia (suppuration) or panaritium (inflammation of the periungual ridge).

Therefore, it is necessary to know the main symptoms of this dangerous disease:

1. usually the appearance of melanoma begins with the appearance of a dark pigmented spot under the nail plate, quite often it has the form of a longitudinal strip. The formation can be painless and even colorless;
2. then the spot grows (over several weeks or even months), becomes noticeably wider in the cuticle area. The color of the formation changes, it can become lighter, darker or unevenly colored from red to bluish-black shades;
3. then the lesion captures the periungual roller, which also changes color and becomes inflamed;
4. the tumor grows, cracks, bleeding sores appear, thinning and deformation of the nail plate begins (nail dystrophy);
5. in the second stage of the disease, ulcers appear on the skin, the tumor takes on a mushroom shape;
6. in the third and fourth stages, the process of accelerated metastasis begins. Sometimes the development of the disease proceeds slowly, and metastasis is of a lymphogenous nature (lymph nodes are affected). With the aggressive development of melanoma, it affects the circulatory system (hematogenous metastasis), and metastases can form already in organs remote from the site of tumor localization.

It is important to consult a dermatologist, having found the first symptoms of nail damage (with any change in the color of the nail plate that does not disappear within 10 days, and with the growth of a pigmented spot).

Diagnosis of the disease

To determine the malignant nature of the neoplasm, dermatoscopy is used (scanning the nail with a special microscope). Also, a blood test is taken to establish the presence of tumor markers (proteins that appear in the blood of a person in the presence of cancer). To determine metastases and other associated pathologies, ultrasound, tomography and radiography are used.

The most accurate determination of the nature of the nail lesion can be given by histology, but before removal of the tumor, the use of biopsy is avoided, since it can cause acceleration of metastasis.

Treatment

Subungual melanoma is treated surgically by removing the tumor along with the affected nail plate, muscle tissue and subcutaneous fat cells. The amount of tissue removed is determined based on the size and extent of the lesion.

After the operation, a histological examination of the tumor sample is performed. Sometimes complete removal of the nail or amputation of the phalanx of the finger is used. If the lymph nodes are affected, lymphadenectomy is also performed - removal of the affected area with metastases.

After the operation, if necessary, appoint:

• chemotherapy (the use of potent drugs);
• radiation therapy (local dosed radiation);
• immunotherapy (the use of immunomodulatory vaccines or serums to activate the body's defenses).

During the rehabilitation period, it is important to take restorative agents.

It is very important not to miss the symptoms of recurrence of the disease: it is necessary to be constantly monitored by a specialist, pay special attention to the condition of the operated limb.

If changes in pigmentation or pain appear in the operated area, you should immediately inform your doctor about it.

Disease prognosis

The subungual survival rate is about 80%. In the second stage of the disease, the prognosis is 10% lower. With metastasis to the lymph nodes, characteristic of the third stage, the survival rate is reduced to 40%. With the formation of metastases in distant internal organs, the prognosis is extremely unfavorable, only 17-24%.