Blackish discoloration of nails (Dermatology)

Dr. Saurabh Pandey., MBBS


Medical Case Details:

A female patient, 18 years old, presented with painful blackish discoloration of nails for 5 months, no history of any trauma. The patient is taking Terbinafine and Fluconazole, but symptoms have not improved. What could be the differentials?


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    Dr. Albana Greca


    I suspect of possible nail melanoma, however, should check her vital organs (cardiac check up, respiratory tests, for anemia,, thyroid)

    Hope that helps.

    ▲ 1
    03.Apr, 01:58pm

    Dr. Prakash Nagar

    Hi there
    If you can post a picture, then discussion will be more precise. Also it is toe nails or finger nails?
    Dioes she has any co-morbidity - cardiac or Metabolic?
    There are many causes but to start with simple one first is always better like a constant pressure on that nail if it only on some specific nails,
    Anemia can lead to but that is usually painless
    Fungal Infections are common
    Melanoma can and it progresses slowly so look for associated signs & symptoms which may not be there in early stages.
    Does she has

    ▲ 1
    05.Apr, 12:38am

    Dr. Saurabh Pandey

    I have attached the photo..but looks like some error.
    Its in her fingernails.
    No other co morbidities.
    No..it's definitely not anemia.
    Can melanoma occur in this age group ..she is just 18.

    06.Apr, 10:40am

    Dr. Prakash Nagar

    Yes, melanoma can occur in this age though it is rare in females at this age.
    Photo could not be accessed. Try once again to upload.

    ▲ 1
    06.Apr, 10:57am

    Dr. Saurabh Pandey

    Well trying again..

    06.Apr, 11:14am

    Dr. M Aamir Chippa

    Possible it can be melanoma, do culture for fungal and biopsy to confirm melanoma

    ▲ 1
    06.Apr, 11:47am

    Dr. D K Verma

    Differental diagnosis is melonoma or fungal infection of nail

    09.Apr, 12:41pm

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