What causes blue and black lines on the toenail?

Hi,

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I need to see a clear picture of your lesion to make a diagnosis. Kindly send a clear picture. Thank you.

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I saw the pictures (attachment removed to protect the patient’s identity). You have removed almost all of the nail plate. So, take great care of the open nail bed, do not get it infected in any way. The nail images before removal show a horizontal band, which is free of any clinical sign of melanoma. Kindly let the nail plate grow back and get back to me after six months for re-evaluation. Thanks and regards.

Hello,

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I will answer all your questions as follows. Clinically, when we see any discoloration in the nail plate, we look for asymmetrical shapes, border irregularities, and color variations. If anyone of them is present, we step on to diascopic and dermoscopic examination. I have looked closely in your case, and there is no such abnormality in the shape, color, or border. There was a clear-cut horizontal band that was homogenous in color. So, in my opinion, it was trauma to the nail, as there is a very tight space below the nail plate, so blood cannot diffuse into the surrounding area. It remains very typical and regular shape. I hope this helps. Take care.