Faint brown streak on mother’s nail ended up being CANCER and left 40-year-old needing her finger amputated
- Elizabeth Misselbrook, 40, was diagnosed with a subungual melanoma
- The rare form of cancer can occur on nails or on the soles and palms
- Doctors spotted it after two biopsies revealed the faint line was dangerous
A mother has told how an unusual brown streak on her nail turned out to be a rare skin cancer that left her needing her finger amputated.
Elizabeth Misselbrook first noticed the suspicious mark on her finger in September 2019 and immediately booked an appointment with her GP.
She was referred to a dermatologist, who removed the nail on her left middle finger for testing in April 2020. Her doctor told her not to worry.
But when her nail grew back later that year, the 40-year-old noticed another line that was ‘much darker and wider’.
Ms Misselbrook returned for another biopsy and was diagnosed with an early-stage melanoma in May 2021.
Doctors told her she should have part of the finger removed because the cancer had already occurred twice on the same finger.
Despite needing the finger to play the flute, the marketing manager from Bracknell in Berkshire, agreed — fearing the cancer would come back worse in the future.
Subungual melanomas, the same type of cancer Ms Misselbrook had, are incredibly rare, occurring in 1 per cent of all skin cancers. They can spread to other parts of the body and become deadly.
Their cause is still a mystery to doctors — although they differ from other melanomas because there is no link to sun exposure.
Elizabeth Misselbrook, 40, from Bracknell, Berkshire, had to have her finger chopped off by doctors after they discovered a brown line on her nail was a rare form of skin cancer
Ms Misselbrook first noticed the suspicious mark on her finger in September 2019, and immediately booked an appointment with her GP
Ms Misselbrook says: ‘I was worried about the long-term consequences like handwriting and playing the flute. I wanted to pay the flute but I want to live more’
WHAT IS ACRAL LENTIGINOUS SUBUNGUAL MELANOMA?
Acral lentiginous subungual melanoma is a form of skin cancer that develops on the palms of a person’s hand, the soles of their feet or beneath their nail.
It usually starts as a flat patch of discolored skin, which can look like a stain, that slowly enlarges over months or years.
Acral lentiginous subungual is a rare form of skin cancer and makes up less than one per cent of melanoma cases in fair-skinned people, who are more at risk.
Its cause is unclear and not related to sun exposure. It is thought to be triggered by genetic mutations and usually affects people over 40.
As the cancer grows, affected lesions can become several centimeters wide, and contain a variety of brown, black, blue-grey and red colors.
Although smooth at first, the affected skin often becomes thick with an irregular surface, like a wart, and may bleed or ulcerate.
Initial treatment usually involves cutting the lesion out. If the cancer has spread to the lymph nodes, these are often also removed.
Source: DermNet NZ
Ms Misselbrook said: ‘Because I’d had two melanomas which had been fully removed, they wanted to make sure it didn’t reoccur so they amputated it before the first joint.
‘I was upset when they said they had to amputate but I was really worried that I’d had two melanomas so I kind of wanted them to make sure it didn’t come back.
‘I was resigned to it. I hadn’t felt unwell at any point and I hadn’t had drug treatment so I felt grateful. I didn’t want to get ill.
‘I was worried about the long-term consequences like handwriting and playing the flute. I wanted to pay the flute but I want to live more.’
Ms Misselbrook went straight to her GP when she first noticed the faint line in 2019 because her doctor friend told her it could be a sign of cancer.
She was referred to a dermatologist seven months later, who removed the nail for a biopsy but tests came back inconclusive.
In December, when the line reappeared but much larger and darker, she went back to her doctor.
The GP was more concerned this time and she was referred to a dermatologist again, who performed another biopsy.
She said: ‘I wasn’t overly worried but enough to make a GP appointment. I didn’t wait. It didn’t itch, it was just a faint, light brown line.
‘It takes time because it’s not a quick “whip that off and have a look” and nails do get funny marks but it was changing and I did have a feeling.
‘The dermatologist said it was suspicious and it’d need to be biopsied again. It was much wider and darker and I was getting worried.
‘It had pigment that had gone onto skin at base of nail so I was a lot more concerned because it had more sinister features.’
This time, the biopsy revealed she had an acral lentiginous subungual melanoma — a rare form of skin cancer that makes up fewer than one per cent of melanoma cases in fair-skinned people.
The percentage is higher in people with darker skin, because they are less at risk of skin cancers linked to sun exposure.
It shows up as a faint line because the cells producing melanin — the brown pigment in skin — spread outwards once activated by the cancer.
Ms Misselbrook has had hand therapy and is waiting for a prosthetic finger so she can continue playing the flute.
She said: ‘Check your nails for anything suspicious that doesn’t grow out, a bruise will grow out.’