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What Causes An Unusual Painless Pigmented Spot On The Toenail?
Posted on
Sat, 13 Jan 2018
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Sat, 13 Jan 2018
Answered on
Thu, 12 Jul 2018
Last reviewed on
Question : I have had this spot on my toenail for about two months now. I don't remember hurting it and it's painless . what could it be ?
Brief Answer:
Possibility of subungual pigment
Detailed Answer:
Hello. Thank you.
I am Dr kakkar (Dermatologist and Venereologist). I have noted your concern and I have viewed the image.
I would like to know have you noticed it drifting distally? Has it changed since you first noticed it? A subungual pigmentation due to hematoma may develop after a period of vigorous activity or sport where no trauma may be recollected. Another possibility is that it is a pigmented onychomycosis.
Regards
Possibility of subungual pigment
Detailed Answer:
Hello. Thank you.
I am Dr kakkar (Dermatologist and Venereologist). I have noted your concern and I have viewed the image.
I would like to know have you noticed it drifting distally? Has it changed since you first noticed it? A subungual pigmentation due to hematoma may develop after a period of vigorous activity or sport where no trauma may be recollected. Another possibility is that it is a pigmented onychomycosis.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
it has not drifted at all. it has stayed in the same spot and it looks the same. I don't really do sports vigorously or anything. it kinda just is hanging out which is why I got concerned.
Brief Answer:
Unlikely to be a Melanoma
Detailed Answer:
Thank you for the information.
I don't think it is a melanoma. A subungual pigment without any communication to the nail matrix or nail folds is unlikely to be a melanoma because functioning melanocytes are only present either in the nail matrix or nail folds but never in the nail bed. Moreover a melanoma of the nail unit usually presents as a longitudinal band that grows with the nail. The fact that it has not changed or changed minimally for 2 months is actually against a melanoma. I suggest you to wait for another 2-3 months and take closeup photos and measure distal drift with a photographic scale. Another possibility is of course of onychomycosis.
Regards
Unlikely to be a Melanoma
Detailed Answer:
Thank you for the information.
I don't think it is a melanoma. A subungual pigment without any communication to the nail matrix or nail folds is unlikely to be a melanoma because functioning melanocytes are only present either in the nail matrix or nail folds but never in the nail bed. Moreover a melanoma of the nail unit usually presents as a longitudinal band that grows with the nail. The fact that it has not changed or changed minimally for 2 months is actually against a melanoma. I suggest you to wait for another 2-3 months and take closeup photos and measure distal drift with a photographic scale. Another possibility is of course of onychomycosis.
Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Nagamani Ng
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