Black Spots on Nails: Could It Be Melanoma?

Black spots on nails?

Doctor, last Friday I took off my shoes and suddenly noticed a red spot on the upper left corner of my big toe.
I thought it was a bruise, but it doesn't hurt when I press on it.
This week it has turned into a small black dot.
Could this be melanoma? Here is the image: http://imgur.com/a/X4FVG.

Also, doctor, can long-term stress and anxiety lead to mental health disorders? I went to see a traditional Chinese medicine doctor, and he said I have a lot of stress, but I don't feel stressed and I don't know how to reduce my stress levels!

AN, 20~29 year old female. Ask Date: 2017/06/14

Dr. Chen Taicheng reply Family Medicine

● The image shows several small black spots, which based on your description, appear to be petechiae caused by injury.
It is recommended to observe them for about a month; if they gradually move forward with the nail, they are likely petechiae.
● Additionally, if you have recently had a tooth extraction or dental treatment, the nails may exhibit this appearance, known as splinter hemorrhages (see image: https://goo.gl/4SXRZU).
Be cautious of the potential for endocarditis; other conditions such as autoimmune diseases (lupus, rheumatoid arthritis, psoriasis, etc.) can also present similarly.
● The likelihood of melanoma is low, but if you are still concerned after a month, you may consult a dermatologist for further evaluation.
● Psychological and physiological aspects are interconnected; if you are experiencing stress adjustment issues, it may be helpful to discuss them with friends or family.
If discomfort persists, please seek consultation with a psychiatrist.
● Wishing you good health, Dr.
Chen Tai-Cheng from Taoyuan Hospital, Department of Family Medicine, cares about you.

Reply Date: 2017/06/14

More Info

When it comes to the appearance of black spots on nails, particularly in the context of your question regarding a small black dot on the left corner of your big toe, it is essential to consider several potential causes. The sudden change in color, especially if it follows an injury, could be indicative of a few different conditions.

Firstly, the black spot could be a result of a subungual hematoma, which is essentially a collection of blood under the nail due to trauma. This often occurs after an injury, such as stubbing your toe or dropping something on it. Initially, the area may appear red or purple, and as the blood coagulates and the nail grows out, it can turn black. If the spot is indeed a hematoma, it should gradually grow out with the nail, and if there is no pain or discomfort, it may not require any treatment.

However, it is crucial to differentiate between a hematoma and other more serious conditions, such as melanoma. Melanoma is a type of skin cancer that can manifest as a dark spot under the nail, and it is characterized by certain features: asymmetry, irregular borders, multiple colors, and a diameter larger than 6mm. If the black spot is changing in size, shape, or color, or if you notice any other concerning symptoms, it is imperative to seek medical attention promptly.

In your case, since the black spot appeared after a potential injury and is not causing pain, it is likely less concerning. However, it is always best to err on the side of caution. A visit to a dermatologist or a healthcare provider for a thorough examination would be advisable. They may perform a dermatoscopic examination or, if necessary, a biopsy to rule out melanoma or other conditions.

Regarding your second question about stress and anxiety, it is well-documented that chronic stress can lead to various mental health issues, including anxiety disorders and depression. While you may not feel overtly stressed, the body can react to prolonged stress in ways that may not be immediately apparent. Symptoms can include fatigue, irritability, difficulty concentrating, and physical symptoms such as headaches or gastrointestinal issues.
To manage stress, consider incorporating relaxation techniques into your daily routine, such as mindfulness meditation, yoga, or deep-breathing exercises. Regular physical activity can also help alleviate stress and improve your mood. If you find that your stress levels are affecting your daily life or mental health, it may be beneficial to speak with a mental health professional who can provide support and coping strategies tailored to your needs.

In summary, while the black spot on your nail could be a benign hematoma resulting from an injury, it is essential to monitor it and consult a healthcare professional for an accurate diagnosis. Additionally, managing stress is crucial for overall well-being, and seeking help from a mental health professional can provide valuable support.

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