Dark spot on toenail and separated nail from bed

[Cthycarlson]

I have questions about both of my great toes. I noticed a dark spot on one great toenail, about 2 mm across, circular so I went to my derm and he said it's probably nothing but let's remove it to be on the safe side (this was yesterday). Today I noticed I have another dark spot , slightly smaller on the opposite side (both are near the base of the nail, on the side). My cuticle is sore too. I wore new shoes two days ago to work, pointy toes and they gave me blisters. Could these dark spots be an injury?

I'm scheduled to go in tomorrow morning to remove the nail and biopsy the spot but I don't want to have it done obviously, if it's nothing suspicious.

My question is what are the chances it's melanoma? I looked up pictures and it doesn't look like any I saw (it's not a streak, it's not brown or black really, it's more dark red or purplish, my toenail is healthy looking otherwise). Also I know it wasn't there two weeks ago, when I last clipped my nails.

My other big toenail is separating from the nail bed on one side. The nail on that part  (about 1/4 of the nail in a stripe) is yellowish and has dark stuff underneath that I occasionally clean out (and it smells bad too).  I also have what looks like very dry skin all over the bottom of my foot and heel. I had athlete's foot for years until about 10 years ago when I took a medicine (by mouth) that got rid of it once and for all-could this be related to the athlete's foot?

I am 36, female, Caucasian.

[Alan Rockoff, MD]

The most common cause of dark spots under nails is trauma.  If you have dark spots under two nails, that would point toward injury, not melanoma.  If your doctor is concerned about melanoma, obviously nail biopsy is required; on the other hand, observation to see whether the dark spot "grows out"--as it would after injury--is another possible approach.  I would, however, have to defer to the doctor who examined you in person.

Your athlete's foot is not likely to be related to any of pigmented issues.

Best.

Dr. Rockoff

[Cthycarlson]

I went back to the dermatologist today, he said most likely trauma but removed the nail anyway. There was nothing on the nailbed and the spot in the nail was dried blood.

The other nail he said was fungus and to leave it alone, it's not so bad.

So, I have no toenail and am in pain but I'm glad the dr. erred on the side of caution.