The appearance of your nails can change due to injury, infection, or other health conditions such as cancer. These are called nail abnormalities. Subungual hematoma and melanoma are two different conditions that affect nails.
The key difference between subungual hematoma and melanoma is their symptoms. Subungual hematoma (or runner’s toe or tennis toe is bleeding and bruising on the fingernail or toenail due to injury, while subungual melanoma (or nail melanoma) is a type of skin cancer that occurs in the nail bed.
CONTENTS
1. Overview and Key Difference
2. What is Subungual Hematoma
3. What is Subungual Melanoma
4. Similarities Between Subungual Hematoma and Melanoma
5. Subungual Hematoma vs Melanoma in Tabular Form
6. Summary – Subungual Hematoma vs Melanoma
7. FAQ – Subungual Hematoma and Melanoma
What is Subungual Hematoma?
Subungual hematoma is the bleeding and bruising on the fingernail or toenail. This condition is also known as runner’s toe, tennis toe, or a blood blister under the nail. Subungual hematoma can be caused by some kind of injury to the blood vessels under the nail bed, like a door slamming on a finger or a heavy object crushing a toe. Moreover, the symptoms of subungual hematoma may include throbbing pain in the nail area, blood pooling under the nail bed, and nail discoloration that starts out as a reddish-purple and eventually turns dark brown and black as the blood clots.
Figure 01: Subungual Hematoma
Subungual hematoma can be diagnosed through physical examination and X-ray of the finger or toe. Furthermore, treatment options for subungual hematoma may include elevating the affected hand or foot and icing the area (applying ice to the skin directly can cause damage), and over-the-counter pain medications to relieve discomfort.
What is Subungual Melanoma?
Subungual melanoma, also known as nail melanoma, is a type of skin cancer that occurs under the nail. The signs and symptoms of this condition may include nails split, crack or deform in some way, an irregular pigments in the nails, nails swelling and inflammation, nails lifting away from the nail bed, developing ulcers, nodules that start to bleed in the nails and discoloration of the skin surrounding the nail. Subungual melanoma can be caused by genetics, biological family history, trauma or injury and moles.
Figure 02: Subungual Melanoma
Subungual melanoma can be diagnosed through physical examination and biopsy. Furthermore, treatment options for subungual melanoma may include amputation, immunotherapy, and radiation therapy.
Similarities Between Subungual Hematoma and Melanoma
- Subungual hematoma and melanoma are two different conditions that affect the nails.
- Trauma can be responsible for both of these conditions.
- Both can be diagnosed through physical symptoms evaluation.
- They can be treated through specific medications and therapies.
Difference Between Subungual Hematoma and Melanoma
Definition
- Subungual hematoma refers to bleeding and bruising underneath the fingernail or toenail.
- Subungual melanoma is a form of skin cancer that develops beneath the nail.
Causes
- Subungual hematoma is typically caused by trauma to the blood vessels under the nail bed, such as a finger being slammed into a door or a toe being crushed by a heavy object.
- Subungual melanoma can be attributed to factors like genetics, family history, trauma or injury, and the presence of moles.
Symptoms
- Symptoms of subungual hematoma include throbbing pain in the nail area, blood pooling under the nail bed, and nail discoloration that progresses from reddish-purple to dark brown or black as blood clots.
- Symptoms of subungual melanoma may involve nails splitting, cracking, or deforming, irregular pigmentation in the nails, swelling and inflammation of the nails, nails lifting away from the nail bed, development of ulcers or bleeding nodules, and discoloration of the skin surrounding the nail.
Diagnosis
- Subungual hematoma is diagnosed through physical examination and may involve X-ray imaging of the finger or toe.
- Diagnosis of subungual melanoma typically requires a physical examination followed by a biopsy for confirmation.
Treatment
- Treatment for subungual hematoma often involves elevating the affected hand or foot, applying ice to the area, and using over-the-counter pain medications to alleviate discomfort.
- Treatment options for subungual melanoma may include amputation of the affected digit, immunotherapy, and radiation therapy, depending on the extent and severity of the cancer.
The infographic below presents the differences between subungual hematoma and melanoma in tabular form for side-by-side comparison.
Summary – Subungual Hematoma vs Melanoma
Subungual hematoma and melanoma are two different conditions that affect nails. These are also known as nail abnormalities. Subungual hematoma looks more like a dark bruise or smudge under the nail whereas subungual melanoma appears as dark lines. Furthermore, subungual hematoma is the bleeding and bruising on the fingernail or toenail due to an injury while subungual melanoma is a type of skin cancer occurs in the nail bed. Thus, this summarizes the difference between subungual hematoma and melanoma.
FAQ: Subungual Hematoma and Melanoma
1. Is subungual hematoma harmless?
- People can get bruises on the ribs or other body parts. People can also get a bruise under their toenails or fingernails called a “subungual hematoma.” Subungual hematomas are very common. Though they are painful, they are not dangerous.
2. How do you fix a subungual hematoma?
- It can be fixed through a technique called as trephination. This is done by using a sharp instrument to pierce the nail and drain the blood, which relieves the pain in the nail area.
3. How do you know if you have subungual melanoma?
- The main symptoms of subungual melanoma include brown or black streaks in the nail without any known injury, the streaks on the nails that increase in size and a bruise on the nail that will not heal or move up as the fingernail grows.
4. Can subungual melanoma be cured?
- Early diagnosis is essential to the successful treatment of subungual melanoma. There is an average 5-year survival rate of 16 to 80 percent in subungual melanoma.
5. What can be mistaken for nail melanoma?
- Both onychomycosis and subungual melanoma may have similar features. Therefore, the primary misdiagnosis of nail bed melanoma is onychomycosis.
Reference:
1. “Subungual Hematoma.” – American Osteopathic College of Dermatology.
2. “Subungual Melanoma: Symptoms, Risk Factors, and Treatment.” Medical News Today, MediLexicon International.
Image Courtesy:
1. “Subungual hematoma, six months later” By John Chew (CC BY-NC-SA 2.0 DEED) via Flickr
2. “Melanoma of thumb” By Wawjak – Own work (CC BY 4.0) via Commons Wikimedia