This Woman Lost Her Thumb to Skin Cancer Caused by Nail Biting

Anyone who's ever had (or still has) a nail-biting habit knows how hard it is to quit the compulsive behavior. From wearing bitter-tasting nail polish to keeping your hands covered by gloves, there are many techniques that nail biters try, only to find that the often-mindless urge is just too strong. If there's anything that can motivate a change, however, it's an especially scary cautionary tale, and this one that just came out of Australia — in which a young woman's nail-biting habit led to skin cancer and the eventual amputation of her thumb — is enough to encourage anyone to keep their fingers out of their mouth.

Courtney Whithorn, a 20-year-old student, had been biting her nails for years as a response to stress, The Sun reports. She went especially hard on her right thumbnail, which at one point she bit completely off. After what little nail grew back (in its new paper-thin texture), Whithorn says she noticed the nail plate area turning black. It was at that point that she sought medical treatment for cosmetic reasons.

"I saw two plastic surgeons, and they were thinking to remove my nail bed to get rid of the black and then put a skin graft over it so at least it would be skin color; I was happy with that," Whithorn tells The Sun. "But before my first surgery to remove the nail bed, the doctors could tell something was wrong and decided to do a biopsy."

After the biopsy and several additional tests, doctors determined that Whithorn had a type of skin cancer called acral lentiginous subungual melanoma — and they linked it to the damage she had done by biting her nails. Doctors performed two surgeries: one to remove her nail bed as originally planned, and another to ensure that all malignant cells were out. They followed up the procedures with a PET scan and removal of two lymph nodes to make sure the melanoma hadn't spread.

"The pigmentation from my thumb had traveled, so it was dark, but none of the malignant cells had traveled yet," Whithorn says of the lymph-node results, explaining that they indicated the cancer was on the cusp of spreading. "Because it had started to travel, the only option was amputation."

The only option was amputation.

Two weeks ago, Whithorn's thumb was surgically removed above the knuckle, and she will have to get regular PET scans and blood tests for the next five years to check for a reoccurrence of the cancerous cells.

“There's not enough research to say what the survival rate is or what the likelihood of it coming back is because we just don't know much about it," she tells The Sun. "I've just cried every time it's been brought up."

The type of cancer Whithorn had is rare among the general population, though it's actually the most common kind of skin cancer diagnosed in people with darker skin tones, according to Miami-based dermatologist Roberta Del Campo. "Acral lentiginous melanoma (ALM) is a form of skin cancer that develops on the palms of the hands, the soles of the feet and/or under the nails," she tells Allure. "When it occurs around your fingernails and toenails, it is called subungual melanoma."

Ted Lain, an Austin-based dermatologist, echoes Del Campo's description, adding that it can be an especially deadly form of skin cancer. "It tends to occur more commonly in African-American patients, and is diagnosed at a later stage since the awareness of this type of cancer is so low," he tells Allure. For the record, Whithorn is white.

Chronic trauma and/or inflammation has been associated with skin cancer development.

Even though ALM isn't very common, it isn't unheard of for injury to lead to cancer. "Any type of constant trauma can lead to continuous inflammation and damage causing abnormal cells, which multiply and by definition can lead to cancerous changes," Del Campo explains. But those cancerous changes aren't typically attributed to ALM.

"Chronic trauma and/or inflammation has been associated with skin cancer development, primarily squamous cell cancer," Lain says. And while that chronic trauma can, as we now know, be the kind caused by severe nail-biting, different types of injuries and conditions are usually to blame. "This is most specifically seen in burn wounds and chronic ulcers."

Regardless of whether or not you're a nail biter, it's wise to be vigilant about any changes you see on your hands and nails, which Del Campo says could be symptoms called Hutchinson’s sign. "You may notice general discoloration on your nails, as well as spots or lines of discoloration extending onto the cuticle and skin where it meets the nails," she says. "As the spot of ALM grows, it may begin to crack or break the nail."

Even if you aren't seeing a crack in your nail, Lain urges making an appointment as soon as you see a change in color. "Any new brown or pigmented mark under a nail that is not a bruise should be evaluated by a dermatologist."

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