Dr. Atishay Bukharia
Dermatology
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Patient's Query
Hello doctor,
I have moles under the nails of each of my big toes. They appeared over the last months, but I do not remember exactly when. The one on my left toe is a round dot in addition to a diagonal line next to it and that goes to the right edge of my nail, while the one on my right toe is just a round dot. The nails themselves are also somewhat cracked and do not look good. I am wondering if there could be cause for concern. I am sending a photo of my toe. Please help me.
Hi,
Welcome to icliniq.com.
Is there any pain? Any change in placement noticed as the nail grows?
Patient's Query
Thank you doctor,
There is no pain. I have not been observing the nails at all. Unfortunately, I only vaguely noticed these spots and did not worry about them until I read about toenail melanomas on the internet recently.
Hi,
Welcome back to icliniq.com.
At this stage nothing is needed (attachment removed to protect patient identity). First of all you need to differentiate nevus with a similar entity of hematoma. So, mark the outer edge of that black area of the nail with a shaving blade and observe it for a few weeks. If the marked outer edge has moved beyond the outer edge of the black area, then it is nevus, otherwise it is a hematoma. The principle is as nail grows hematoma will also move with it, but nevus will remain in the same position.
Secondly, you are suffering from onychomycosis. I suggest you to apply Amorolfine nail lacquer three times in a week. Also, I suggest capsule Sporanox (Itraconazole) 100 mg twice daily for consecutive seven days in a month for three months. Consult your specialist doctor, discuss with him or her and take the medicine with their consent. This is known as pulse dosing, taking medicine for 7 days and then a medicine free period of 21 days in a month.
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Dermatology
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