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What Does A Dark Streak On Toe Indicate?

Posted on Mon, 28 Jul 2014

Question: Hello from Australia! I am 71 years old and have a dark streak on my third toe. It just appeared and I noticed it whilst drying my foot about three weeks ago. I am fair skinned and this streak is not painful, I can't remember any injury and I am concerned about it as it seems to be getting a little wider at the bottom. My local GP said he thought I must have injured it and says to wait 6 weeks and he will have another look at it as biopsy is painful and invasive. My question is, how likely is it that it is a form of melanoma? Thank you for your advice.

Answered by Dr. Kalpana Pathak (22 minutes later)

Brief Answer:
details below

Detailed Answer:
Hi,
Thanks for writing to us.
From the description, it seems you are having melanonychia. It is a dark brown or black pigmented band over nail plate. It is seen in association with chronic paronychia( nail fold infection), fungal infection of nail, trauma, acral lentigenous melanoma, glomus tumors, warts etc. Sometimes it is normally seen in people who are dark complexioned.

Of all these underlying causes ,melanoma warrants concern.
Your melanonychia could be due to melanoma in these conditions
Age- Fifth to seventh decade( u are in seventh decade)
Breadth of band is more than 3 mm and margins are variegated/irregular
Changes in nail bed morphology
Digit involved. Melanoma is more commonly seen in thumb,great toe and index finger involvement.
Pigment spreading to nail fold or other areas of digit
If there is family history of melanoma or dysplastic nevus

Please upload an image of your lesion so that I can examine it and comment further. Also let me know if any of these above mentioned risk factors are present in your case
If at all there is a doubt, please meet your dermatologist to get an excisional or punch biopsy done.

Injury induced haematoma or pigmented band usually are painful.

Hope this helped.
Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Kalpana Pathak (39 minutes later)

Thank you Dr Kalpana, it does seem to be a little bit wider at the proximal end and a little darker. I will have to work out how to send you a photo. There is no melanoma in my immediate family but my father and his two brothers died of other cancers.

Answered by Dr. Kalpana Pathak (3 hours later)

Brief Answer:
details below

Detailed Answer:
Hi,
You may click an image of affected area and then upload it on this health portal by clicking on upload report/image icon which is on right side of your query page. You may also send the pics to YYYY@YYYY . Please mention ATTN: Dr Kalpana Pathak in subject line.
I am waiting for the pics!
Warm 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. Chakravarthy Mazumdar