The 5 Stages Of Nail Melanoma
Nail melanoma is a life-threatening skin cancer that grows to affect the nails, usually the big toe and thumb. This disease can prove to be very deadly, however treatments are readily available if diagnosed early.
This disease is often referred to as, Malignant Melanoma of Nail Unit or Nail Unit Melanoma.
- The pigment producing cells of the body, called Melanocytes, is where the Melanoma cancer develops. The Melanocytes are responsible for giving our skin its color.
- The development of Melanoma cancer, usually begins from a finger or toenail, however thats not always the case.
- It has the tendency to affect the areas around such as the sides of nail or the nail bed. In fact, it may also spread to other parts of the body, if not treated on time.
- The big toe or thumb is usually the first to get affected, however it may vary according to each case.
- The Nail Unit Melanoma is divided into 3 main types:
- Nail Melanoma is most common in light/fair skinned people as opposed to dark skinned people.
There are 5 stages of Nail Melanoma, stated as follows
Stage 1: aka Stage O Melanoma
This stage is also referred to as Melanoma in situ, meaning site of origination of Melanoma. At this point, a tumor has formed on the outermost layer of the skin, epidermis.
Stage 2: aka Stage I Melanoma
This stage is further categorized into two:
Stage IA: At this stage, the tumor is less than a mm deep and has no signs of an ulcer.
Stage 3: aka Stage II Melanoma
The Abcdes Of Melanoma
The first five letters of the alphabet are a guide to help you recognize the warning signs of melanoma.
A is for Asymmetry. Most melanomas are asymmetrical. If you draw a line through the middle of the lesion, the two halves dont match, so it looks different from a round to oval and symmetrical common mole.
B is for Border. Melanoma borders tend to be uneven and may have scalloped or notched edges, while common moles tend to have smoother, more even borders.
C is for Color. Multiple colors are a warning sign. While benign moles are usually a single shade of brown, a melanoma may have different shades of brown, tan or black. As it grows, the colors red, white or blue may also appear.
D is for Diameter or Dark. While its ideal to detect a melanoma when it is small, its a warning sign if a lesion is the size of a pencil eraser or larger. Some experts say it is also important to look for any lesion, no matter what size, that is darker than others. Rare, amelanotic melanomas are colorless.
E is for Evolving. Any change in size, shape, color or elevation of a spot on your skin, or any new symptom in it, such as bleeding, itching or crusting, may be a warning sign of melanoma.
If you notice these warning signs, or anything NEW, CHANGING or UNUSUAL on your skin see a dermatologist promptly.
A is for Asymmetry
D is for Diameter or Dark
E is for Evolving
E is for Evolving
What Does A Normal Vs An Abnormal Mole Look Like
Normal moles are usually round or oval and smaller than a pencil eraser. They are one consistent color , with a clear border. Most people have less than 50 moles. You can be born with moles, develop them with age or even have some disappear.
Cancerous, or malignant, moles may vary greatly in appearance. To help identify moles that might indicate melanoma, think of the letters A-B-C-D-E:
- A | Asymmetry: Mole is an irregular shape, such as if one side looks different than the other
- B | Border: Mole has irregular, ragged, notched or scalloped borders
- C | Color: Mole has more than one color or uneven shading
- D | Diameter: Mole is bigger than a pencil eraser
- E | Evolution: Mole changes in some way
Talk to your doctor, if you notice any skin changes that seem unusual.
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Less Common Types Of Skin Cancer
Kaposi sarcoma
This is a rare form of skin cancer that develops in the skins blood vessels and causes red or purple patches. It often attacks people with weakened immune systems, such as individuals with AIDS, or in people taking medications that suppress their immune system, such as patients whove received organ transplants.
Merkel cell carcinoma
Merkel cell carcinoma causes firm, shiny nodules that occur on the surface or just beneath the skin and in hair follicles. Merkel cell carcinoma most often appears on the head, neck and torso.
Sebaceous gland carcinoma
This rare but aggressive cancer develops in the skins oil glands. Sebaceous gland carcinomas which usually appear as hard, painless nodules can develop anywhere, but frequently occur on the eyelid, where they can be mistaken for other eyelid problems.
How Do People Find Signs Of Melanoma On Their Own Skin
Performing a skin self-exam as often as recommended by your dermatologist is the best way. While examining your skin, you want to look for the following:
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Mole that is changing in any way
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Spot that looks different from the rest of the spots on your skin
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Growth or spot on your skin that itches, bleeds, or is painful
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Band of color beneath or around a nail
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Sore that doesnt heal or heals and returns
The ABCDEs of melanoma can help you find changes to a mole, freckle, or other spot on your skin.
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Melanoma Images: How To Try To Spot Melanoma
Below you can see six images of the most common type of melanoma, known as superficial spreading melanoma.
The pictures in this article were licensed from DermNet NZ.
Confoundedly, not all suspect lesions that are later diagnosed as melanoma had the characteristics seen in these melanoma images.
To help we have created a walkthrough of the principal differences between common moles and melanomas.
Melanomas may not always resemble a mole. They may look like the amelanotic melanoma shown below.
If you find something that resembles this on your skin, it is very possible it is not a melanoma, but its best to get it checked out without delay.
Squamous Cell Carcinoma Early Stages
The second most common form of cancer in the skin is squamous cell carcinoma. At first, cancer cells appear as flat patches in the skin, often with a rough, scaly, reddish, or brown surface. These abnormal cells slowly grow in sun-exposed areas. Without proper treatment, squamous cell carcinoma can become life-threatening once it has spread and damaged healthy tissue and organs.
Read Also: How To Identify Basal Cell Carcinoma
What Do The Early Stages Of Skin Cancer Look Like
People can have stages of skin cancer and yet not feel ill, which makes early treatment and diagnosis a little challenging. But by being aware of the early stages of this disease, you can protect yourself and seek effective treatment right away. Do you have scaly patches, raised growths, or sores that do not heal? Dr. Jurzyk from Advanced Dermatology Center in Wolcott, CT can help you identify and treat all types of cancer of the skin, keeping you from fatal complications.
Melanomas That Could Be Mistaken For A Common Skin Problem
Melanoma that looks like a bruise
Melanoma can develop anywhere on the skin, including the bottom of the foot, where it can look like a bruise as shown here.
Melanoma that looks like a cyst
This reddish nodule looks a lot like a cyst, but testing proved that it was a melanoma.
Dark spot
In people of African descent, melanoma tends to develop on the palm, bottom of the foot, or under or around a nail.
Did you spot the asymmetry, uneven border, varied color, and diameter larger than that of a pencil eraser?
Dark line beneath a nail
Melanoma can develop under a fingernail or toenail, looking like a brown line as shown here.
While this line is thin, some are much thicker. The lines can also be much darker.
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A Small Number Of Patients Will Get A Local Recurrence Of Melanoma Very Near To The Excision Site
Do you know what a local recurrence looks like?
First off, its always possible that a new primary tumor can develop, by sheer chance, right beside the site of a surgically removed melanoma.
The second tumor in this case will have nothing to do with the first.
However, a local recurrence of a melanoma has a more finite range of appearances.
What Are The Causes Of & Risk Factors For Scalp Melanoma
Sun exposure is the leading cause of all forms of melanoma. Because the scalp often receives a significant amount of sun exposure, that means there is a high risk for melanoma and other forms of skin cancer in this area. In addition to sun exposure, regularly visiting tanning beds, radiation treatment, and chemical exposure can all contribute to the development of skin cancers.
In addition to the underlying causes of skin cancer, numerous factors can increase the risk of developing scalp melanoma, including:
- Taking immunosuppressive medications
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Early Warning Signs Of Melanoma
The key to detecting melanoma early is to know what to look for and where to look for it. This isnt always easy, as melanoma can be a master of disguise. It may look like an age spot, a bruise, a sore, a cyst, a scar or a dark line beneath your nail. You may not feel a melanoma, but there are times that it may itch, hurt or bleed.
The ABCDE method may help you determine whether an abnormal skin growth may be melanoma:
- A is for asymmetry: Does the mark look different on each half?
- B is for border: Are the edges jagged or irregular?
- C is for color: Is your lesion uneven in color with specks of black, brown and tan?
- D is for diameter: Is your lesion getting larger?
- E is for evolving or elevation: Has your lesion changed in size, shape or texture over the past few weeks or months?
If the answer to any of these questions is yes, or even maybe, see a dermatologist for a proper evaluation. The only way to be sure whether a mole is melanoma is to visit a doctor.
Other melanoma warning signs may include:
- Sores that dont heal
- Pigment, redness or swelling that spreads outside the border of a spot to the surrounding skin
- Itchiness, tenderness or pain
How Fast Does Subungual Melanoma Grow
Subungual melanoma often begins as a visible pigment band on the length of the nail plate . For weeks or months, the pigment band:
- Grows, especially in the proximal termination .
- Becomes more irregular in pigmentation, including light brown and dark brown.
- Extends by becoming involved in the adjacent nail fold .
- Can develop a lump, ulcerate or bleed.
- Can lead to thinning, cracks or deformation of the nail plate .
However, up to half of all cases of subungual melanoma are amelanotic . Nail melanoma may form a lump under the surface of the nail, lifting it . Sometimes it may look like a verrucous wart. It is usually painless, but the advanced tumor invades the underlying bone, which can origin a grim pain.
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What Does A Melanoma Look Like In Early Stages
Often the first sign of melanoma is a change in the shape, color, size, or feel of an existing mole. However, melanoma may also appear as a new mole. People should tell their doctor if they notice any changes on the skin. The only way to diagnose melanoma is to remove tissue and check it for cancer cells.
Each Type Of Skin Cancer Looks A Little Different
According to Dr. Wofford, Most people think of melanoma, which typically looks like a dark spot on the skin, but actually, there are many different types of skin cancer. Each type looks a little different, so in addition to understanding how to tell the difference between benign skin spots and cancerous lesions, it may be beneficial to learn a little more about the appearance of each type of skin cancer.
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The Ugly Duckling Sign
The “ugly duckling sign” is another warning method to help identify melanomas. Usually, moles on your body look quite similar to each other. However, compared to other moles, melanomas tend to stand out like an ugly duckling. The more you check your skin and become familiar with it, the easier it becomes to spot an ugly duckling early.
Less Common Skin Cancers
Uncommon types of skin cancer include Kaposi’s sarcoma, mainly seen in people with weakened immune systems sebaceous gland carcinoma, an aggressive cancer originating in the oil glands in the skin and Merkel cell carcinoma, which is usually found on sun-exposed areas on the head, neck, arms, and legs but often spreads to other parts of the body.
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Exams And Tests For Skin Cancer
If you think a mole or other skin lesion has turned into skin cancer, your primary care provider will probably refer you to a dermatologist. The dermatologist will examine any moles in question and, in many cases, the entire skin surface. Any lesions that are difficult to identify, or are thought to be skin cancer, may then be checked. Tests for skin cancer may include:
- The doctor may use a handheld device called a dermatoscope to scan the lesion. Another handheld device, MelaFind, scans the lesion then a computer program evaluates images of the lesion to indicate if its cancerous.
- A sample of skin will be taken so that the suspicious area of skin can be examined under a microscope.
- A biopsy is done in the dermatologists office.
If a biopsy shows that you have malignant melanoma, you may undergo further testing to determine the extent of spread of the disease, if any. This may involve blood tests, a chest X-ray, and other tests as needed. This is only needed if the melanoma is of a certain size.
Continued
It can be challenging to tell if a skin change is unimportant or, in fact, is a sign of developing skin cancer. Skin cancer is not uncommon, as one in five Americans will develop skin cancer before age 70. Learning to spot the warning signs is vital. When identified early, skin cancer is highly curable. Do you know what to look for or when to seek medical advice?
Checking Yourself And Your Loved Ones
Start by checking your entire body, including skin not normally exposed to the sun. You could ask for help from someone else to check difficult-to-see areas, such as your back, neck and scalp.
We recommend that you follow the Ugly Duckling rule. The idea behind the Ugly Duckling rule is that you compare your moles with each other. If any mole stands out or looks different from that of nearby moles, it is the ugly duckling, and we advise you contact a doctor to get an expert opinion.
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Basal Cell Carcinoma Early Stages
Basal cells are found within the skin and are responsible for producing new skin cells as old ones degenerate. Basal cell carcinoma starts with the appearance of slightly transparent bumps, but they may also show through other symptoms.
In the beginning, a basal cell carcinoma resembles a small bump, similar to a flesh-colored mole or a pimple. The abnormal growths can also look dark, shiny pink, or scaly red in some cases.
What Does Early Skin Cancer Look Like
It can be challenging to tell if a skin change is unimportant or, in fact, is a sign of developing skin cancer. Skin cancer is not uncommon, as one in five Americans will develop skin cancer before age 70. Learning to spot the warning signs is vital. When identified early, skin cancer is highly curable. Do you know what to look for or when to seek medical advice?
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What Is The Treatment For Skin Cancer
Treatment for basal cell carcinoma and squamous cell carcinoma is straightforward. Usually, surgical removal of the lesion is adequate. Malignant melanoma, however, may require several treatment methods, including surgery, radiation therapy, and chemotherapy or immunotherapy or both. Because of the complexity of treatment decisions, people with malignant melanoma may benefit from the combined expertise of the dermatologist, a cancer surgeon, and a medical oncologist.
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When To See A Healthcare Provider
It is always vital to seek medical advice early for a skin change, no matter how small it may appear. Make an appointment with your healthcare provider for a skin exam if you notice:
- Any new changes, lesions, or persistent marks on your skin
- A mole that is asymmetrical, has an irregular border, is multicolored, is large in diameter, is evolving, or has begun to crust or bleed
- An “ugly duckling” mole on the skin
- Any changes to your skin that you are concerned about
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Acral Lentiginous Melanoma Nail
- The frequently used ABCDE rule is not always helpful in nail acral lentiginous melanoma. This is because of the anatomy and continuous outgrowth in of the nail plate.
Picture 3 : Nail acral lentiginous melanoma
Image source : ncbi.nlm.nih.gov
This nail lesion can be seen from the distal third of the nail bed noting that it caused nail detachment.
Please see : ABCDE rule of malignant melanoma
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