Nail disorders care

Bruising, streaks, bumps, or cracking in your nails could be the result of a mild injury or fungal infection. But if nail changes persist, get worse, or don’t have an obvious cause, they could indicate a more serious nail disease or condition. Major and minor nail problems can look a lot alike, so it’s important to have them checked by an experienced dermatologist who specializes in nail health.

Penn Medicine is home to the only adult nail specialty clinic in the region and the only pediatric nail clinic in the U.S. Our dermatologists, dermatologic surgeons, and dermatopathologists are recognized nationally and internationally for their skill in diagnosing and treating the most perplexing nail disorders. We also offer second opinions for complex nail diagnoses. Our cutaneous pathology services team routinely evaluates nail specimens from across the country.

Whether your nail concerns are cosmetic, painful, or potentially serious, we have the experience and tools to help. We offer the latest techniques in nail specimen processing and imaging to ensure accurate diagnoses, especially in difficult or unusual cases. When needed, our team can readily collaborate with other specialists throughout Penn Medicine, including podiatrists, hand surgeons, rheumatologists, infectious disease experts, and oncologists.

Changes in the nail, especially dark streaks, discoloration, or unexplained bleeding, can sometimes be signs of skin cancer. One type, called subungual melanoma, begins under the nail and can be easily missed or misdiagnosed. That’s why unusual nail symptoms are best investigated by experts with experience in nail tumors.

At Penn Medicine, our dermatologists are specially trained to recognize early signs of cancer. We work closely with oncologists to confirm the diagnosis and create a personalized treatment plan if cancer is found. This may include biopsy, surgical removal, or advanced therapies, depending on the type and stage of the cancer.

We also offer second opinions and pathology reviews for previously biopsied nail tissue. If you or your provider are unsure about a diagnosis, we can help clarify the findings and suggest next steps.