A baby can be born with a brown pigment “in” a nail. What are the odds that this can be melanoma?

Certainly, if your newborn has a pigmented area under a fingernail, this needs to be examined.

“Congenital cutaneous melanoma, or melanoma that is present at birth, is a very, very rare phenomenon which typically arises under one of three circumstances,” says Kara Shah, MD, an adult and pediatric dermatologist and founder of Kenwood Dermatology in Cincinnati, OH.

“Nail melanoma may arise from any part of the nail unit, including the nail matrix, which is the part of the nail unit under the cuticle that forms the nail plate,” points out Dr. Shah.

Dr. Shah explains the three circumstances under which a baby can be born with congenital subungual melanoma, a subset of cutaneous melanoma.

“Transplacental transfer of melanoma cells from a mother with metastatic melanoma to her unborn fetus; spontaneous development of a cutaneous melanoma arising on otherwise normal skin; or the development of cutaneous melanoma arising within a congenital melanocytic nevus prior to birth.

“Congenital melanoma of the nail unit has never been described in the literature to my knowledge, and while theoretically possible, would be exceedingly rare.”

Nobody will state that a baby has never been born with a nail melanoma simply because every single person who’s ever been born has never been subjected to some kind of nail-examination registry.

So like Dr. Shah says, a newborn with a melanoma affecting the nail is theoretically possible, e.g., a baby born in a developing country who had congenital subungual melanoma that was never diagnosed due to lack of medical care and lack of awareness on the part of the parents.

Whether you’re just really curious about this topic, or have noticed a birth mark or line in your baby’s fingernail or toenail and are beginning to panic, here are some facts that will reassure you.

Deducing the Rarity of Nail Melanoma in Babies

• Melanoma overall (nail, skin, eye, mouth, mucosal) is uncommon.

• The subungual type accounts for 0.7% to 3.5% of all melanoma cases worldwide.

• It is SO rare for nail melanoma to start developing in childhood, that the Archives of Dermatology has this to say:

“To our knowledge, the medical literature reports only 6 cases of subungual melanomas in children.”

Archives of Dermatology 2007;143(12):1589-1603

Here’s another metric for how rare it must be – if it even has ever occurred – for a baby to be born with melanoma of a nail:

The case of Nora Hosier. As of June of 2017, Nora was two. She was born with cutaneous melanoma – on her scalp.

Here is an excerpt from an article that appeared on the blog site for University of Michigan Health.

The excerpt should reassure the daylights out of you that your baby – if he or she has a pigmented band in a nail – probably doesn’t have melanoma.

Of course, have the spot inspected by a dermatologist, but you can expect additional reassurance when the dermatologist makes a final assessment.

Dr. Shah is triple board certified: general dermatology, pediatric dermatology and general pediatrics. Her special interests include melanocytic nevi (moles), melanoma, psoriasis, acne, atopic dermatitis/eczema, hair and nail disorders, birthmarks and genetic skin diseases.
Lorra Garrick is a former personal trainer certified by the American Council on Exercise. At Bally Total Fitness she trained clients of all ages for fat loss, muscle building, fitness and improved health.