View Full Version : Subungal Melanoma (toenail)

06-30-2005, 02:50 PM

I have been diagnosed with subungal (nailbed) of the big toe. It is the second occurance (we think). I have been scheduled to have the distal portion of my big toe amputated. Does anyone have any idea what this type of surgery will involve and what the recovery issues will be. I cannot seem to find any pictures of what this type od amputation will look like.

I do know that it does not seem to have spread so we caught it early, Thank God.

I am very nervous about the surgery, though I am grateful that that is all it is.

Does anyone have any insight.


07-01-2005, 05:25 AM
well Mary

first off welcome to the board. I have done some reading up on subungal melanoma and there is quite a bit of info. Even found some photos of the surgical proceedure, (But the photos I viewed were of the thumb not the big toe) unfort I cannot direct you, but if you do the search and just be patient and check it all out, I am sure you can find the pictures you need to find.

I am sorry this is happening to you. Subungal M is very rare I believe, and I am glad you were able to get such prompt treatment. Do your research but do keep in mind, the best person to ask about the surgical stuff is your doctor... if there is a restriction that would cause you to be careful of bearing weight on your foot, they have to tell you that. Go and ask your doctor that is part of their job, to make sure you are well aware of all the stuff that is happening to your body.

Hope everything goes well, and I wish I could be of more help. There are loads of sites dedicated to melanoma of all types..... perform the searches for the info you require.


07-05-2005, 01:54 PM
Dear Mary
I'm learning about ALM (Acral Lentingous Melanoma) right now too. My husband is recovering (1 wk post op today) from left great toe amputation. This cancer is extremely rare. Have you had any tests to be sure the cancer hasn't gone to your lymph nodes?
My husband found a tender swollen spot in his groin, an aspiration biopsy was done and they found it had cancer cells. So, when they removed his toe last week, they removed the lymph nodes in the groin area too.
He is in a walking cast that comes up to his knee. You may have phantom pain for awhile, so don't be alarmed if it feels like your toe hurts. Take your pain medication while you recover.
My husband is doing very well. Surgery was tuesday, he was home wednesday night, but everyone is different. Be sure to ask questions of your doctor and nurses. They are there to take care of you. I hope this is of some help. I'll try to find my way back here later to see if you posted. I wish you all the best. God bless. Sputnik

07-19-2005, 09:08 PM
Hi Mary - How are you doing? How was your surgery? Will you be having any Interferon or Chemo treatments? I hope you had nothing but good results and excellent pathology reports.
My husband is doing well with his recovery. His is also referred to as ALM, subungual just indicates where the primary lesion originated (I think). They removed the lymph nodes in his groin and found 3 of 10 were cancer. He has been staged IIIC and will be starting treatment through National Clinical Trial within a few weeks. I'm nervous, but keeping the faith. It's so hard to watch someone you love have to deal with something like this.
Take care. Sputnik

07-31-2005, 09:34 AM
I am a 41 year old white male. I have no history of melanoma or cancer. I am in excellent health.

Having said that, I am worried about a black spot under the big toenail of my right foot. My girlfriend says it's been there since November, although I don't remember it being there that long.

The spot has definitely gotten bigger. So recently it occured to me that it could be melanoma. I did some research on the internet and determined that it is possible to get melanoma underneath the toenail.

As I remember, it did not start as a green spot. It was always a dark spot. At first I thought it was a hematoma, or a bruise. But I don't remember injuring that toe in the last year.

Any help you could give me would be appreciated.

Ga Lady
07-31-2005, 03:40 PM
Bill, I dont want to cause you to worry anymore than you are but...I would say go to a dermatologist. Not a medical dr. My medical dr said my 'pink spot' was nothing to worry about...welll that spot that was nothing to worry about has now been excisied and I have approx over 20 some odd stitches and I am 36 years old. Good Health and I looked mine up on the internet and didn't see the FIRST one that looked like mine either. Go check it out..When in doubt..check it out. If we could put websites on I would tell you to look into a melanoma board that is wonderful and thathas helped me alot. There are people there too with the same questions. Don't panic just check it out. Tell us what you find out! Prayers going up for you!

07-31-2005, 04:18 PM
If its in the nailbed I would probably see a dermatologist, plastic surgeon (for biopsy), or (and probably the best choice) a podiatrist.

Until proven differently, any abnormal growth in a nailbed is cancer. Most are not melenoma, but carcinoma or mearly a nevus(cancer potential). If its either of the last two, the surgery will be a pain but probably not disfiguring (might have a small scar).

08-12-2005, 04:44 AM
Definately go see a Dr. Mine was found by my podiatrist. Believe it or not mine had to color at all like the last post said....assume any abnormal growth is cancer until proven otherwise. Let me know how it goes.

The top half of my big toe was amputated on 7/8. The path reports showed that it was a Clark IV so today I am going to have a Sentinal Node Biopsy. I guess better safe than sorry. I will keep you posted.

Bill, make sure you get to the Dr about that toe.

08-16-2005, 11:07 AM
Bill, how are you doing? Did you go to the Dr.

Sput, let me know how you guys are doing.


08-30-2005, 07:44 AM
Hi Mary-

I'm 27 and Caucasian. I've been struggling with ruling out subungual melanoma in my right thumbnail. I had a nail matrix biopsy a year ago because I had a small black line running the length of my nail. The biopsy only proved that melanocytes were present. It did not show them to be atypical. My plastic surgeon said I was OK and it was probably a result of a benign mole. He had removed the entire lesion and expected my nail to grow back without another line. Wrong. My nail grew back with a line in almost the exact same spot. I went to another derm. and he told me I should have another biopsy. He wants me to go to a plastic surgeon who specializes in hands. I'm really freaking out. Not only about the possibility of getting my finger (on my dominant hand) amputated, but also about the prospect that I've had this for almost 3 years now. My new derm. is telling me that the plastic surgeon last year did not go far enough into my matrix to disprove melanoma. My plastic surgeon is telling me my derm. doesn't know what he's talking about. I hate these doctors. They don't seem to be in the business of taking care of patients - only in covering their behinds. I'm just very frustrated and scared.

Have you recovered well from surgery? Did they sample any of your lymph nodes? I sure hope it hasn't spread. Do you have any advice for me? May I ask how old you are and if you're Caucasion? I know that's completely inappropriate, but it's kind of key in this type of cancer.

I'm going for a consult with the new plastic surgeon in Oct. I couldn't get in any sooner! Then I will set up an appt. for the biopsy. Please respond if you get a moment.

Thxs and god bless,

08-30-2005, 08:01 AM
Hi Tracy

well the only thing I can think of is there is really no sense worriying about what has passed behind you. You are doing right by marching forward, and seeing a plastic surgeon who does hands. My surgeon was the same kind (I live in Canada) though my melanoma was on my back.

You are doing right, and maybe you can try? to get your appointment moved up? Up here it takes about 3 months to see a plastic surgeon then a many many long weeks just to get into the hospital for the leision removal, but once a dx is reached it seemed like no time happened tween then and the full WLE I had.

The loss of a finger is bad, I concur but the loss of your life, is worse. You cannot change what went on before, be it right or wrong. Follow your gut instincts.


06-01-2007, 01:13 PM
I am a 52-year-old caucasian female, scheduled for removal of suspicious toenail & biopsy of nail and nail bed next Friday.

Back in November (7+ mos ago), I noted a bruised spot on my left big toe under the nail and assumed I had stubbed it or something. This also had happened several years ago and it took quite awhile for the nail to eventually drop off (can't recall which foot) and grow back. Shortly after noticing the spot, I had a pedicure and had all my toenails painted.

Fast forward 5 mos later (March), I noticed that my left big toenail had not grown out at all but all my other nails had; the polish was halfway grown out on all my other toes. I took nail polish remover and removed the polish on my left big toe. That is when I remembered about the "bruise." Now the whole nail bed was blackish/purple.

I figured I had waited long enough for the nail to fall off, plus it was starting to hurt with certain shoes or when turning in bed, so saw my family physician in early April. He is the one who said "you can get melanoma under the nail" but he did not think that was it (I had never heard of that before, and I have worked over 10 years as a medical transcriptionist, plus both my husband and I see a dermatologist regularly to have pre-cancerous areas removed). Since I told him I believed I had injured the nail before the "bruise" appeared, and since the nail was somewhat loose, he suggested I just leave it alone and let nature take its course.

Fast forward another 2 mos: I started thinking about how I had injured the toe in the first place and realized I only ASSUMED I had done so; I could not remember actually injuring it. Since the nail had not yet fallen off and my family physician mentioned MELANOMA UNDER THE NAIL, I made an appointment with a podiatrist and told him my concerns. I saw him yesterday and he did not hesitate to schedule the procedure, which I am anxiously awaiting.

I found this board by surfing the web for more info. I am worried sick because it has been over 7 mos since I first noticed something was wrong . . . :confused:

How are others doing out there? Well, I hope. Jody

06-22-2007, 07:06 AM
Hi Jody,

I'm a 26 yr old caucasian female. I was diagnosed with subungual melanoma of a thumbnail matrix almost 2 years ago. Mine had been present since I was 18, so it was 6 years from the time that I first noticed it to the time that I was finally diagnosed and had surgery. I too thought mine was a bruised nail (even though I could not remember how I bruised it) and so did many doctors and nurses over the course of 6 years. Luckily for me my cancer was slow growing and was still in a very early stage after 6 years. I was treated with surgery alone and I am still cancer free after 2 years. I had a lymph node biopsied at the time of surgery and that was free of cancer cells.
Shortly after my diagnosis my older sister had a toenail biopsied for a "bruise" that had been present for a year. Her's was benign - no melanoma, just an ordinary mole.

If your biopsy comes back as positive for melanoma or moderate to severe dysplasia I would recommend having your biopsy samples sent to a cancer center for a second opinion if possible. I would also recommend getting and keeping copies of all of your biopsy reports, even if it is benign.

Good luck and I hope everything turns out well.
- Kate

09-05-2007, 03:18 AM

I'm a 33 year old caucasion female. I had a suspected subungual melanoma removed from my big toe 12 days ago. I am still waiting for results, but what I am really shocked about is that "it" is growing back already!!!

The surgeon said it could come back but I assumed he meant years, not days. My toe nail was lifted to remove it but the nail was put back down to act as a splint and it has come back in exact same spot.

I have another month to wait 'til I know for sure if it is cancer I'm dealing with, although all the doctors seem to think it is.

Does anyone else have any experience of this?

Nicky :)