Lymph node metastasis in cancer progression: molecular mechanisms, clinical significance and therapeutic interventions
Is It Toenail Fungus Or Melanoma?
Toenail melanoma is a rare cancer that develops underneath the fingernail or toenail. You can also get toenail fungus from the overgrowth of fungi in, under, or on the nail. The two conditions can look similar, but toenail fungus is more common.
Toenail melanoma is another name for subungual melanoma, which means "under the nail." Toenail fungus is also called onychomycosis.
Keep reading to learn more about subungual melanoma, differences from toenail fungus, and the symptoms, causes, and treatment for both.
Melanoma is a type of skin cancer. Subungual melanoma is uncommon. It accounts for only 0.7%–3.5% of all malignant melanomas worldwide. This form of melanoma occurs in all racial groups, but it is more common in People of Color.
Subungual melanoma is rare, but it is deadly if left untreated. One of the biggest challenges with treating subungual melanoma is diagnosing it early and correctly.
It's often difficult to diagnose because this type of cancer often has a dark brown or black streak on the nail that's similar in appearance to other benign causes.
There are, however, symptoms to look out for that can make diagnosis easier for your doctor.
Read on to learn about how doctors diagnose subungual melanoma vs. Nail fungus.
Diagnosing subungual melanoma
A diagnosis of subungual melanoma is uncommon and difficult to determine. Here are certain warning signs to look out for:
Diagnosing toenail fungus
Subungal melanoma and nail fungus have different causes.
Causes of subungual melanoma
Unlike other forms of melanoma, subungual melanoma doesn't appear to be related to overexposure to the sun's UV rays. Instead, some of the causes and risks of developing this cancer include:
Causes of nail fungus
Certain behaviors and preexisting conditions that can affect your risk of nail fungus include:
There are many overlaps between nail fungus and nail cancer. Since it's easy to mistake nail cancer for a fungal infection, you should see a doctor immediately to get a definitive diagnosis.
See a doctor immediately if you suspect you have toenail fungus or subungual melanoma.
Since the prognosis of subungual melanoma gets worse the longer it takes to diagnose, it's better to be safe and get any possible symptoms checked out and cleared as soon as they appear.
Fungal infections are not life threatening, but the 5-year survival rate for subungual melanoma can vary dramatically depending on how early the cancer is identified. It can range from 15%–97%.
If you wait too long for diagnosis and treatment, there's a risk of cancer spreading throughout the organs and lymph nodes.
Read on to learn how doctors treat nail fungus vs. Subungual melanoma.
Treatment of nail fungus
If you have nail fungus, treatment is relatively straightforward. Your doctor will commonly recommend:
Treatment of subungual melanoma
Diagnosing and treating subungual melanoma is much more involved.
Once your doctor performs the initial assessment and determines you might have subungual melanoma, they'll commonly suggest a nail biopsy.
A nail biopsy is the primary diagnostic tool for making a definitive diagnosis. A dermatologist or nail specialist will remove some or all of the nails for examination.
If there's a diagnosis of cancer, depending on the severity and how early it was found, treatment can include:
Subungual melanomas are difficult to diagnose because they're rare and can appear similar to other common afflictions of the nail, such as fungal and bacterial infections.
See your doctor immediately if you have a fungal nail infection and possible subungual melanoma symptoms.
Since early detection is crucial to a positive prognosis, it's important to be proactive in examining your nails for any signs of melanoma. Don't hesitate to see a doctor if you have toenail fungus or subungual melanoma.
Understanding Skin Cancer: Symptoms
The symptoms of skin cancer can be subtle, meaning you may not notice that there's anything wrong, at least at first. Over time, that changes, and the symptoms become more clear.
"The symptoms of skin cancer become more obvious the longer the skin cancer has time to develop," says Philip Scumpia, MD, a clinical dermatologist and dermatopathologist at the UCLA Health Jonsson Comprehensive Cancer Center in Los Angeles.
The timeline, says Scumpia, can depend on the type of skin cancer that you have.
"Some skin cancers, like melanoma, may grow and change rapidly, while others like basal cell carcinoma, may take months to years to change," he explains.
Diagnosing skin cancer early is critical. Not only does early skin cancer require less invasive treatment, it also has the highest chance of getting rid of the cancer before it spreads to other parts of your body. When the cancer spreads, it becomes what's called metastatic, and it's much harder to treat. This happens most often in a dangerous type of skin cancer called melanoma, which is much less common than some other kinds of skin cancer, such as basal cell carcinoma.
"In many cases, when skin cancer is detected and treated promptly, it can be cured," says Michele Green, MD, a cosmetic dermatologist at Northwell Lenox Hill Hospital in New York City. "To prevent skin cancer from progressing and affecting other systems, it is crucial to identify and treat it as soon as possible."
Basal cell carcinoma may appear on sun-exposed skin as:
Squamous cell carcinoma may appear on sun-exposed skin as:
The general warning signs of skin cancer include:
"Many times, [skin cancers] start as a subtle pink, red, skin-colored, tan, or brown spot that does not go away," says Scumpia.
The following are other general signs of possible skin cancers:
Remember, skin cancer can present differently in different people, so yours may not look like someone else's. As Green points out, your skin color and any existing skin conditions — eczema, for example — can affect what your skin cancer looks like.
"Conditions like eczema, which causes dry patches, can influence how skin cancer appears, as eczema causes red, itchy skin, which can alter the appearance of the cancer," says Green.
Melanoma is the most deadly type of skin cancer. It grows faster than more common types of skin cancer, such as basal cell carcinoma and squamous cell carcinoma. It's more likely to spread to other parts of your body. Though it only accounts for about 1% of all skin cancer cases, it causes the most skin cancer deaths. But it can be cured if caught early. That makes it critical to quickly spot the symptoms of this skin cancer. Warning signs of melanoma include changes to existing moles or new growths on your skin, often — though not always — in places that get exposed to sunlight. Signs to look for include:
Your moles can be cancerous even if they only have one or two of the above signs. Don't ignore any moles that show any of these signs.
In addition to moles, melanoma also can be indicated by open sores, patches of scaly skin, and raised bumps.
You also can develop hidden melanoma, meaning it occurs on parts of your body not exposed to the sun, such as:
Certain types of hidden melanoma can develop inside your body. This can make them very hard to detect. For example, you can develop melanoma in your eye (ocular melanoma), which can cause vision changes. Mucosal melanoma develops in your mucus membranes, found in your nose, mouth, esophagus, and elsewhere. A third type — acral lentiginous melanoma — develops under a fingernail or toenail or on the palms of your hands or soles of your feet. Hidden melanomas are more common in brown or Black people. Acral lentiginous melanoma is also more common in Asian people.
Also referred to as squamous cell carcinoma, this is the second most common type of skin cancer, after basal cell skin cancer. It develops in the squamous cells, which make up the middle and outer layers of your skin. Most of the time, it's caused by ultraviolet (UV) light from the sun or artificial light sources such as tanning beds and tanning lamps. It's not often fatal. But if left untreated, it can grow and spread to other parts of your body, causing serious complications, which can be life-threatening.
The symptoms of squamous cell skin cancer include:
Squamous cell skin cancer can develop anywhere on your body. Most often, though, it occurs on parts that get exposed to the sun. In brown and Black people, it is more likely to develop on skin that does not get exposed to the sun. It can develop on your genitals, inside your anus, and in the tissue under your fingernails and toenails.
The most common type of skin cancer — and, worldwide, the most common of all types of cancer — is basal cell skin cancer, which affects nearly 1 in 5 Americans. It develops in the lower part of your epidermis, which consists of the outer layers of your skin. Commonly referred to as basal cell carcinoma (BCC), it's rarely fatal. But it can destroy skin and be disfiguring if not treated early. Fortunately, it often can be cured with a simple outpatient procedure called Mohs surgery, which removes the cancerous growth. It's very rare for BCC to spread, or metastasize, but if that happens, it can be life-threatening. So make sure to get treated right away.
BCC usually develops on sun-exposed skin, often on your head or neck. But it also can occur on parts of the skin not typically exposed to the sun, such as your genitals.
Here are the symptoms of basal cell skin cancer to watch for:
Basal cell skin cancer can look different in different people. If you see any unusual signs on your skin, even if they don't match the above descriptions, play it safe and call your doctor.
Familiarize yourself with how skin cancers look so that you can recognize anything that appears abnormal on your skin. Set aside time to examine yourself on a monthly basis.
"Regular self-examinations are an effective method for detecting potential skin cancer in your body," says Green. "Everyone should perform these examinations, but it is especially important for those at higher risk of developing skin cancer."
Here's how to do it: Examine your skin from head to toe using a full-length mirror and hand mirror to check your mouth, nose, scalp, palms, soles, backs of ears, genital area, and between the buttocks. Cover every inch of skin and pay special attention to moles and sites of previous skin cancer. You won't be able to see all parts of your body, so ask your spouse, partner, or someone else you feel comfortable with to help. If you find a suspicious growth, have it examined by your dermatologist.
"It is likely that benign conditions may also be identified accidentally, but it is better to be safe than sorry," says Scumpia.
The ABCDE rule is used to help spot melanoma, the most serious form of skin cancer. Each letter in the rule stands for a different sign to look for. It can be helpful when you do your self exams.
A for asymmetry. This means that one half of a mole looks different from the other half.
B for border. Melanoma moles have irregular borders that may appear ragged or notched or have indistinct edges, and the color of the mole may spread into the skin around it.
C for color. A melanoma mole can come in a variety of colors. It may show shades of brown, black, and tan, possibly with areas of white, red, pink, gray, or blue.
D for diameter. Most melanoma moles measure about 1/4 inch in diameter and may grow larger.
E for evolving. A melanoma mole changes in appearance over weeks or months.
To use this rule most effectively, ask your doctor for a brochure with pictures, Scumpia recommends. Go through the pictures with your doctor to better understand what you're looking for. Then, when you do your self exam, you'll have the rule and images to guide you.
"Anything that reminds patients to perform a self exam is a good tool to raise awareness of spots on their skin," says Scumpia.
Remember, the ABCDE rule may not capture all melanomas. If you have suspicious skin growths, changes to existing moles, wounds that don't heal, or other concerning signs, call your doctor.
The ugly duckling sign
In addition to the ABCDE rule, the ugly duckling sign can be helpful when you do a self exam. Basically, what you're looking for is a mole or other spot that's different from those elsewhere on your body.
"Either this is the only spot that the patient has, or this is the only spot that looks different when you compare it to all the other spots," says Scumpia.
If you find an ugly duckling sign, get it checked right away by a doctor.
Skin cancer can appear in many ways. Its symptoms depend on the type of skin cancer as well as how advanced it is.
If you have any concerns about abnormal looking moles, spots, or other growths on your skin, see a doctor as soon as possible.
Skin cancer often can be cured easily when caught early.
What does skin cancer look like?
Skin cancer comes in many forms. It can cause new growths on your skin and changes to moles already there. How it looks depends largely on the type of skin cancer and how far it has progressed. If you notice anything suspicious on your skin, have it checked out.
What are the first signs of skin cancer?
It often begins with subtle spots that may be close in color to the rest of your skin. Such spots do not go away and likely will change over time as the cancer progresses.
Does skin cancer itch?
Not always, but some cancerous growths do cause itching. This usually happens only after they've grown quite a bit.
Does skin cancer hurt?
It can. Skin cancer growths may be painful or tender to the touch, and some may cause a burning sensation when exposed to the sun.
Toe Nail Sign Could Be Potentially Deadly Cancer - What To Look For
Often tucked away in socks during the winter, our toes might not get much attention, but they're actually barometers for overall health. They can signal potential issues like nutrient deficiencies, diabetes, and even serious circulatory problems.
However a LloydsPharmacy Online Doctor survey revealed that 50% of Brits neglect regular checks of their toes or toenails. And one in six are oblivious to the fact the state of their toes could flag health worries.
Sheena Bagga, Pharmacist Prescriber at LloydsPharmacy Online Doctor, has shed light on the significance of toe and nail health, highlighting eight symptoms that should set off alarm bells. She emphasised: "While often overlooked, your toenails and feet play a huge role in your overall health and it's important to pay attention to their condition.
"While everyone's toes look different, healthy nails should have a smooth surface with light pink or translucent colouration without much variation in shade or hue."
Yellow nailsOne issue to be vigilant about is yellow discoloration of the toenails, which can suggest an infection affecting any part of the nail, leading to changes in colour, texture, and thickness. It may also indicate nail psoriasis characterised by a pitted appearance, or separation from the nail bed, reports the Mirror US.
To avoid toenail infections, it's advisable to maintain short, clean and neat nails. It's also important to wear a fresh pair of socks daily and ensure your shoes fit properly.
Dark stripes on the nailThis condition, known as Melanonychia, appears as a brown or black band running lengthwise along the nail. While usually benign and simply a variation in nail pigmentation, in rare instances, it can be an indicator of Subungual Melanoma, a form of skin cancer.
To help prevent Melanonychia, it's essential to maintain good nail and foot hygiene. Avoiding nail trauma is key - if you do injure your nail, let it heal fully and refrain from picking at it.
Swollen toesToe swelling can result from various conditions, including lymphatic problems, poor blood circulation, or even gout. Therefore, it's important to consult your GP if you're experiencing other worrying symptoms such as pain, aching, or difficulty moving.
Gout is a type of inflammatory arthritis characterised by sudden, severe joint pain, often in the big toe, caused by the accumulation of uric acid crystals in the joints. It's more likely to affect overweight individuals, and adopting a healthy diet that promotes weight loss can help manage the condition.
Toe swelling can be as a result of less serious reasons including extended periods of sitting or standing, ill-fitting shoes, excessive body weight, dehydration, or a high-salt diet. Embracing a wholesome, nutritiously balanced lifestyle and regular physical activity may alleviate these common conditions.
White toenailsOften, the appearance of white lines or spots, known as "leukonychia", on your nails comes from accidental trauma such as stubbing your toe. Occasionally, they may flag up protein, zinc, or iron deficiencies.
White toe nails can be a fungal infection (Image: ©Daniela White Images via Getty Images)Fungal infections could turn nails white while making them brittle and crumbly, particularly if your feet often remain warm and damp—like when you wear trainers for long durations and they become hot and sweaty.
Though a rare occurrence, entirely white nails can signal more serious concerns, possibly indicating systemic health issues like liver cirrhosis, hyperthyroidism, or diabetes. If ever there are accompanying symptoms that raise concern, it's imperative to consult with your GP to determine the underlying cause.
Blue discolourationA blue tint to your nails, coupled with an abnormal chill in your toes, might indicate compromised blood circulation, often associated with Raynaud's disease. This ailment leads to the narrowing of small arteries that deliver blood to your digits.
Regular physical activity can enhance blood flow, which is beneficial for managing Raynaud's symptoms and maintaining a healthy weight.
Itchy toesAthlete's Foot, a common fungal infection, presents as itchy white patches between your toes. It can also affect the soles or sides of your feet, sometimes causing fluid-filled blisters.
To help prevent Athlete's Foot, ensure to thoroughly dry your feet after washing them, particularly between your toes. Also, wear clean socks every day - cotton is preferable as it allows the skin to breathe more easily.
Ulcers on toes or feetUnlike a blister that forms under the skin, an ulcer is a break in the skin's surface, appearing as an open wound. It's crucial that these are cared for to minimise any risks of infection.
While the wound is exposed, it can leave you susceptible to developing an infection, which in severe cases can lead to amputation. A diabetic foot ulcer is classified as an open wound or sore on the skin that takes a long time to heal.
Spoon NailsRegularly inspecting your toenails is important. If your toenails change shape and appear curved or 'spoon' shaped, it could indicate an iron deficiency or anaemia.
Iron is vital for producing healthy red blood cells and maintaining proper nail health, so it's important to consult a healthcare provider who may recommend taking a supplement.
Whilst issues with toes and nails can often be easily remedied, if you're experiencing symptoms due to conditions like diabetes, poor circulation, or nutritional deficiencies, it's vital to maintain a healthy, balanced diet for your overall wellbeing.
Comments
Post a Comment