Nail Biopsy for Nail Unit Tumor: Common nail tumors

A nail tumor is a rare condition that occurs when tissue under the nail plate gets damaged from injury or disease. Most commonly nail tumor growth is benign, but in some cases, it may be malignant. These need to be removed surgically because both tumors can affect the nail and cause deformities such as changes in nail texture and color (dystrophy). Many of these tumors occur in tissue around but not in the nail.

 

Noncancerous tumors are soft tissue tumors that don’t spread to other parts of the body. It is not life-threatening, usually removed by surgery, and doesn’t recur. It includes:

  • Myxoid cysts:

This tumor causes fluid-filling swelling where the cyst stems are connected to tissue that is on the top of the last finger segment. It looks like a shiny papule at the edge of the nail and contains a sticky fluid that may be tinged with blood when it bursts. Most of them are benign and treated by draining the fluid with a sterile needle. In severe cases, surgical intervention is required to fix it, but they usually reoccur.

  • Pyogenic Granulomas:

This tumor causes slight raised bumps due to excessive growth of capillaries which cause swelling on the surrounding tissue. It may not be painful but tends to bleed very easily and it can occur to anyone.

Usually, they disappear after a while, or you can remove them surgically with the help of the doctor by a procedure like curettage or electrodesiccation. Before that, it’s a good idea to get a biopsy to ensure that the tumor isn’t malignant. This tumor can regrow even after being removed.

  • Glomus Tumors:

It mainly occurs in subungual locations or under the nail. It is caused by malformation of the veins rather than a skin tumor. It’s also found on the fingertip or in the foot and affects toes or fingernails. They are mostly benign, but due to their small size, it is difficult to diagnose so conduct a biopsy when possible.

 

 

Cancerous tumors are tumors that can spread to other tissues and cause cancer. It can recur even after treatment, and it is life-threatening. When doctors suspect cancer, they run a biopsy and recommend complete removal of the tumor as early as possible. It includes:

  • Bowen disease or Squamous Cell Carcinoma:

It is a type of skin cancer that affects the epidermis due to abnormal, uncontrolled growth of the squamous cells. It may be caused due to high exposure to ultraviolet light and is more common in men than women. Besides the nails, it can affect any area of the body, especially parts that frequently get exposed to the sun such as the face, hands, arms, and legs. However, it rarely affects the genitals and mucous membranes.

Bowen’s disease is restricted to the epidermis and doesn’t affect the deeper skin layer. That’s why it is also called intraepidermal squamous cell carcinoma. Early detection and complete removal of squamous cell carcinomas can cure this tumor. A biopsy is recommended for early detection. Surgical procedures include radiation, electrosurgery, photodynamic therapy, or laser to treat it.

  • Malignant Melanoma:

It is a type of skin cancer that affects melanin-producing cells which not only affect your skin but also your eyes, nails, and in rare cases your internal organs. It looks like a dark stripe on the nail. Commonly found on the great toe or the thumb, it may be present on any toe. Usually, the skin of the nail bed develops a tumor.

The melanoma of the nail bed is also known as subungual melanoma. If it originates from under the nail plate, then it’s called ungual melanoma and if it originates from the skin beside the nail plate is called periungual melanoma.

Dark-skinned people are mostly affected by this tumor. It generally affects people in the age group of 40 to 70 years. Early diagnosis with a biopsy can help you find it. If it’s found to be malignant, surgical removal of the melanoma nail tumor is recommended.

 

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