Introduction:Nail apparatus melanoma (NAM) does not behave in a similar pattern as other forms of melanoma and the classical risk factors, like sun exposure, may not apply to NAM1,2,3. However, there has been debate if regular nail treatment with ultraviolet light (UV) lamp at nail salons increases risk of melanoma. Interestingly, NAM accounts for 10-17% of cutaneous melanoma in Asians4,5, as compared to 0.31-2.8% in Caucasians6,7. More than 70% of nail salons in America are operated by Asians8,9. In addition, a Korean study has shown predominance of NAM in females10, and Korea has been arguably, at the forefront of cosmetic consumerism and export11where manicure and pedicure have become a basic cosmetic routine.
Objective: Our purpose was to perform a literature review of NAM in association with cosmetic nail treatment. Nail UV lamps mainly emit UVA and a study by Shipp et al showed that dose exposure in a single session ranges between 0-8 J/cm2, with a recommended 2-weekly regime for the maximum cosmetic effect when the native nail grows out13. Comparatively, PUVA, or psoralen-ultraviolet A therapy, more than doubles the risk of melanoma after 250 sessions which averages at about 2500 J/cm2 14,15.
Findings: The risk of melanoma with nail UV lamps has been regarded as low16,17,18. However, the initial steps to a manicure before UV curing of nail polish gel is to first remove the nail polish from 2 weeks ago by gentle scrapping motion with a cuticle pusher and then buffering the nail with successively finer grit to attain a healthy shine and consistency for the next application12. Stress or trauma is a preceding risk factor for NAM10,19, with an observed tendency to occur in the right hand more than the left20 on the thumb and great toe10.
Conclusion: The entirety and frequency of cosmetic nail treatment, from the mechanical stress of removing nail polish and buffing the nail, to UVA-induced DNA damage from UV lamps, could cumulatively present a risk for developing NAM.