Brown Line on Mom’s Nail Turns Out to Be Rare Form of Melanoma

One day, 45-year-old Lauren Koltcz glanced down at her hands and noticed a tiny brown streak on her thumbnail. As a busy mom of two, she didn't think much of it at first and simply brushed it off.

“I just put it on the back burner. I think a lot of people in similar situations tend to put others first, and I just let it go for a while,” says Lauren, a middle school teacher from North Royalton, Ohio.

But what seemed harmless turned out to be a rare form of melanoma. “When you think about melanoma, moles and other spots on your skin come to mind – but who would think to check their nails,” asks Lauren.

She initially assumed the spot was from a vitamin deficiency and simply continued painting her nails, “If you put nail polish over it, you can't see it – out of sight, out of mind.”

Over time, however, what started out as a thin line began spreading across her nail. She’d cut her nail, but even then, it wouldn’t go away. Eventually, she started searching for answers online.

“I came across a video of a dermatologist saying, ‘If you see these signs on your nails, go to your doctor and get them checked out.’ She was showing something that looked exactly like what was under my nail, so I immediately made an appointment with a dermatologist,” says Lauren.

After her nail was examined, it was determined that it needed to be investigated further by her care team, which included dermatologists Cheyana Ranasinghe, MD, and Chairman Emeritus of Cleveland Clinic’s Department of Dermatology Allison Vidimos, MD.

“I was concerned because the pigmentation on her nail was very dark, there were different shades of brown and the spot was wider than 3 millimeters,” says Dr. Vidimos.

Because of Dr. Vidimos’ concerns, Lauren’s nail was removed, and a biopsy of the brown area was taken. The results showed she had subungual melanoma – a skin cancer that develops under the nail.

“I just couldn’t believe it. Everybody knows someone who’s had cancer, and now I was one of them,” says Lauren, who was diagnosed in March 2025.

Subungual melanoma, or nail melanoma, is a serious and rare type of skin cancer, accounting for 0.7% to 3.5% of all melanomas worldwide. It usually appears as a vertical streak on the nail and is most likely to develop in the big toe, thumb or index finger. However, it can impact any nail and discoloration doesn’t always occur. That’s why it’s important to take note of any nail changes.

“Remembering to check your nails along with your skin is crucial. Unlike other skin cancers, subungual melanoma isn’t linked to sun exposure, and the exact cause is unclear – so staying vigilant is key,” says Dr. Vidimos.

While not all nail spots are related to melanoma, Dr. Vidimos stresses bringing them up to your doctor as a precaution. That’s because early detection is key.

“When this type of cancer is caught early, there's over a 95% survival rate. But if it’s neglected and not diagnosed at an early stage, it can spread to the lymph nodes and make treatment more challenging,” says Dr. Vidimos, who adds nail melanomas are often diagnosed late because people don’t think to check their nails.

In Lauren’s case, she caught it at stage 0, meaning the melanoma was only in the top layer of skin (the epidermis). Since this was the case, Lauren underwent surgery to remove the cancer and some of the tissue around the area to ensure no cancer cells were left. The procedure was a success. Lauren currently shows no evidence of cancer.

"After the surgery, I didn’t have to go through chemotherapy or radiation. I just kept thinking, ‘How lucky am I that I caught it in time and had such great doctors to treat it,’” says Lauren.

Moving forward, Lauren continues to regularly follow up with her dermatologist. With all this behind her, she’s grateful to be able to enjoy more motorcycle trips with her husband and quality time with her children. Through sharing this story, Lauren and her care team hope to raise awareness about the possibility of nail melanoma and the importance of early treatment.

“Make sure to regularly check your nails for any changes in color or contour. If there’s any question at all, make the time to get in to see a dermatologist. This is a type of cancer that's very curable if caught early,” says Dr. Vidimos.

Lauren adds, “My message is for all the parents and anyone who’s out there running this race of a life: You have to take time to take care of yourself, because if you don’t, who's going to care for the people you love if you’re not here? Don’t put off any symptoms or skip out on your annual exams.”