Dark mark under toenail

[Wishimaywishimight]

I know no-one here can offer re-assurance but just wondering if anyone had anything similar?

DH showed me a dark mark under his toenail recently. It's quite large, covers much of his middle toenail. He said it had been there a couple of months, he had assumed he had hit it off something but it wasn't going away so he showed it to me. He then made a GP appointment and saw the GP this morning who took a sample and is sending it off for testing. She said "hopefully" it's just a fungal infection but it needs to be tested for melanoma as it goes in a straight line.

He is not at all worried (not a worrier in general!) but I, of course, am freaking out and thinking the worst.

To me it sounds like the GP is concerned so wondering what are the chances it is just fungal or is it likely to be melanoma??

I hope all goes well, but was surprised to read that GP took a sample of something they thought could be melanoma. Is that appropriate?

It's always important to get any dark spots under nails checked. I'm guessing the GP is ruling out a fungal infection before seeking a dermatologists opinion.

I had something similar and it turned out the be a dried blood spot under the nail which took a few months to grow out. I took a photo and zoomed in and it sort of looked like dried blood. Saw a doc who also thought dried blood and advised to wait to see if it grew out which it did. Hopefully the same for your DH.

Is your husband dark skinned? Anything dodgy is pretty rare in Caucasian people.

Hi all, thanks for your responses.

@Weneedamathstutor hopefully something simple like that although the GP did want to get it checked out.

@LeakyPipes he said she scraped something from under his nail, cut a piece of the nail and also took a photo - all of which were sent off for checking.

@ProfCee She said "hopefully" a fungal infection but it did need to be checked out.

The sample taken by the GP was sent to a hospital (private as we have insurance) and DH has received an appointment for August 2024 with a dermatologist. I am hoping this means they are not terribly concerned however DH is going to go back to the GP to discuss it and see what, if any, communication they have had with the hospital.

I had a look at the hospital website, there are a number of dermatologists there and the one who DH will be seeing has his 'areas of interest' on the website listed as: Pigmented lesions, Laser Skin Resurfacing, Cosmetic Laser Surgery. Some of the other dermatologists have cancer / melanoma listed so I am hoping this means they are not concerned about that as his appointment is not with any of these specialists. I'm telling myself this of course, I really don't know!

In any event, if the GP thinks we should push for a sooner appointment then he will contact the hospital and ask to be put on a cancellation list or see one of the other dermatology consultants. I would not want to wait 9 months if there are any suspicions at all.

@BeverleyMacker (love the username!!). No, he is very fair skinned - pale skin, light hair and freckles!

Hi OP - I had a dark straight line on the edge of my little toe that I was concerned about. The GP looked under a microscope and was looking to see if it was attached to the nail bed, which would have been more of a concern - mine wasn’t. So he took a scraping and in the meantime I saw a private dermatologist (three week wait) and the result came back on the same day as my appointment that it was an unusual nail fungus - luckily for me. Here’s hoping your husband has a similar result. Best wishes OP

@Julsey07 Glad to hear yours was nothing serious, hoping DH's outcome will be similar! I have no idea if it is attached to the nailbed, the GP didn't reference that and it's hard to tell just from looking at it.

The Gp is quite right to always be aware of the possibility of a discolouration under the nail being a melanoma , this is a very rare event and from memory incidence is 0.1% per 100000 people, but even though it’s rare obviously it does happen and no practitioner wishes to miss one , hence the gps caution . The most likely cause is bruising under the nail or a fungal infection . If it’s bruising the site of the discolouration will gradually grow out with the nail so if you carefully measure the distance from the base of the nail you can monitor this . Otherwise monitor is closely ( regular photographs ) and if it looks like it’s getting bigger then go back to the Gp ?

@Fridaypodiatrist Thank you so much for this, really useful to have an expert (judging by your username!!) opinion. I also really appreciate the re-assurance (noting, of course, that even the smallest chance needs to be properly checked out). That's a great idea, to monitor, I will do this immediately. It doesn't appear to be bruising though, he said it's been there a couple of months, he kept thinking it was just a bruise / blood but it hasn't gone away unfortunately.

He is going back to the GP next week for regular bloods anyway so plans to chat with her about the appointment he's received and to see if she is satisfied with this. If not, we will definitely chase up a sooner dermatology appointment.

Check out how bob marley died. Do not ignore toe problems!!!

if You don’t think it’s a bruise as you’ve got private health insurance why not ask for a private referral and find a consultant dermatologist who can see your dh soon ( you don’t have to stick with the one offering a 2024 appointment), if you contact their secretaries explain your concerns and ask what their earliest availability is you should be able to find something within the next week/ two weeks I’d have thought ? as I’ve said no one wants to miss a melanoma so will take your concerns seriously … even if your insurance doesn’t cover this if you can self fund the appointment maybe it’s probably worth it for your own peace of mind if nothing else ??

@FFridaypodiatrist The August appointment is private (it's at a fully private hospital).

Having worked as a medical secretary in a (different) private hospital I know that non-urgent referrals are not prioritised (obviously) so am taking this as the hospital, having received the samples/photo are not concerned however DH is going to chat with the GP next week. If she is not satisfied we will definitely source a sooner appointment with another dermatologist.

Perfect … wishing you all the best

@FFridaypodiatrist Thank you, I do appreciate your responses / advice.

@bababasaclover Definitely will not be ignoring!!

August 2024 you say @Wishimaywishimight.
That's a long way off.
Could you contact them and ask if a cancellation comes up your dh would take it.
Or try another private hospital ?

@LaLadyEloise1 Depending on what the GP says next week (i.e. if she has received communication from the hospital re the samples/photograph) we will absolutely pursue a cancellation or alternative consultant/hospital. We're in a city, with many dermatologists/hospitals so will not wait until August if there is any doubts at all.