An Innocent-Looking Shadow on Her Thumbnail Turned Out to be Subungual Melanoma

Maria’s message is: “when in doubt, get a biopsy.” Ten years ago, Maria Sylvia noticed a vertical streak on her thumbnail that at the time she thought was “cool.” She called it her racing stripe.

That was until recently, when the stripe was diagnosed as melanoma.

Maria recently explained to Newsweek that she decided to warn others and described her bout with cancer in a post on TikTok. She was inundated with fifteen million views.

A Rare Form of Cancer

Maria, now living in Washington D.C., noticed the thumbnail streak when she was sixteen. Maria was active in sports and had to see several sports doctors. However, even though the thumbnail streak became more pronounced, she never gave it much thought until her visit to a podiatrist for an ingrown toenail two years later.

When the podiatrist noticed the streak, he recommended that Maria see a dermatologist. At the dermatology appointment, the doctor diagnosed the streak as being associated with a possible mole under the nail. The change in pigmentation (the stripe) was associated with nail growth.

The doctor told Maria that there was about a one percent chance that she had subungual melanoma. Therefore, she did not think a biopsy would be necessary. And lastly, the dermatologist told Maria she was not at all concerned due to Maria’s ethnicity and age.

The dermatologist told Maria to notify her if there was any change in color or size. So Maria stopped thinking about it for eight uneventful years until 2021. A friend read an article with photos of subungual melanoma. She convinced Maria to get a biopsy.

The biopsy was taken in January 2022 and within a few days, Maria was diagnosed with early-stage subungual melanoma. She was told that this type of cancer can remain at stage 0 (in situ) between ten to thirteen years before progressing to stage 1. Then it becomes very aggressive.

Because the cancer was in an early stage and had not yet spread to other body parts (metastasized), Maria avoided thumb amputation. However, in March of 2002, surgeons at Johns Hopkins in Baltimore removed the nail bed along with the top of the thumb to the tendon and bone. On the 25th of March, once the doctors felt that her system was clear of cancer, Maria received a skin graft.

Maria is now deemed as being high risk. She was told that she must see her doctors every three months for two more years followed by six-month visits for three years.

About Subungual Melanoma

Subungual melanoma is rare and often severe form of skin cancer occurring in skin lying under toenails or fingernails.

Maria’s cancer represents only 0.7 to 3.5 percent of melanomas worldwide. However, it accounts for seventy-five percent of melanomas in those of African descent, twenty-five percent of melanomas in those of Chinese descent, and ten percent of melanomas in those of Japanese descent. Maria’s dermatologist no doubt also relied on evidence that the cancer mostly affects females over sixty or males over seventy.

Maria’s Post on TikTok

Maria felt that the majority of TikTok responses were encouraging. However, she felt concerned that she may have unintentionally raised some anxiety.

Maria said that she was inundated with photos of toes and fingers with streaks, and people asking her whether they also had melanoma. She did her best to explain that she is not a doctor and urged them to see a dermatologist.

She was saddened to read the many messages from people describing the loss of their loved ones to subungual melanoma. Many had ignored the nail discoloration until it was too late. Others admitted that they feared seeing a doctor. Yet Maria was always pleased to read messages from survivors.

A Successful Video

Maria was rewarded for her efforts to alert others to early detection. She received numerous messages from people saying that they heeded her advice and made appointments with a dermatologist.

She still looks back and regrets that she was not more proactive in getting a biopsy at her first appointment. But then she admits that she was young and trusted her doctor’s judgment. Maria just asks people to be cautious, as she is proof that even a one percent risk can be lethal.

Rose Duesterwald

Rose Duesterwald

Rose became acquainted with Patient Worthy after her husband was diagnosed with Acute Myeloid Leukemia (AML) six years ago. During this period of partial remission, Rose researched investigational drugs to be prepared in the event of a relapse. Her husband died February 12, 2021 with a rare and unexplained occurrence of liver cancer possibly unrelated to AML.

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