Red flag warning for rare cancer that can appear in your nails

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A simple condition affecting your nails can be a sign of a rare tumour, scientists have found. Researchers say a white or red coloured band along the length of the nail can indicate a risk of developing cancerous tumours or the skin, eyes and kidneys.

A study by the National Institutes of Health of NIH found people who had a rare inherited disorder, BAP1 tumour predisposition syndrome, were likely to have onychopapilloma. This is a benign nail condition which leaves nails thickened and often with a red streak running down their length.

Other signs of the condition include white or brown streaks running lengthways down the nail. The nail can also split or splinter and there can be signs of blood under the nail.

While most people in the general population who have onychopapilloma would only have it in one nail those with the BAP1 syndrome have been found to have it in multiple nails. It is hoped the findings will help identify people at risk of having BAP1 with the researchers urging: "Referral for genetic counselling is recommended when this distinct nail finding involves multiple nails."

Edward Cowen, head of Dermatology Consultation Services at NIH’s National Institute of Arthritis and Musculoskeletal and Skin Diseases wrote in the JAMA Dermatology journal: "This finding is rarely seen in the general population, and we believe the presence of nail changes that suggest onychopapillomas on multiple nails should prompt consideration of a diagnosis of BAP1 tumour predisposition syndrome."

The study examined data from 47 people aged from 13 to 72 from 35 families who all carried variants of BAP1. It found about 87% of participants with BAP1 tumour predisposition syndrome had nail changes, such as nail splitting and splinter haemorrhages, including many that were consistent with onychopapilloma.

Onychopapillomas affected multiple nails in about 97% of people with BAP1 tumour predisposition syndrome who had the nail condition, the researchers reported in JAMA Dermatology. In the general population, the condition often affects only one nail.