How fingernails might help doctors detect cancer risk

Fingernail abnormalities might help detect a condition linked with various cancers, including uveal and cutaneous melanoma, basal cell carcinoma, mesothelioma and renal cell carcinoma, according to a study published Friday in the JAMA Dermatology journal.

Researchers found that BAP1 tumor predisposition syndrome - a condition associated with the BRCA1 gene - was also associated with a "high rate of nail abnormalities consistent with," onychopapilloma. Those are rare benign tumors of the nail matrix and bed.

Public awareness of BRCA1 - a gene linked to breast and ovarian cancer - increased following actress Angelina Jolie's announcement that she carried the gene and had preventative bilateral mastectomies to decrease her risk of developing breast cancer in 2013. Jolie's mother, Marcheline Bertrand, died of breast cancer. According to Beth Israel Lahey Health, the "Angelina Jolie Effect" resulted in an increased number of women seeking genetic testing for the gene.

BAP1 tumor predisposition syndrome is also an inherited disorder, per the National Library of Medicine. It increases the risk of a variety of cancerous and noncancerous tumors, most commonly impacting the skin, eyes, kidneys, and the tissue that lines the chest, abdomen, and outer surface of the internal organs (the mesothelium).

When it functions normally, the BAP1 protein acts as a tumor suppressor and it prevents cells from growing and dividing too rapidly. To do this, mainly removes ubiquitin molecules from proteins.

"Mutations in the BAP1 gene lead to production of an altered protein that cannot function normally and may be broken down prematurely," the National Library of Medicine explained.

Authors of the recent study said that the association between BAP1 tumor predisposition syndrome and nail abnormalities could facilitate detection of the condition. In a cohort study of 47 patients with BAP1 TPDS, nail abnormalities were detected in 41. Abnormalities included leukonychia, splinter hemorrhage, onychoschizia, and distal nail hyperkeratosis.

"These findings suggest that multiple onychopapillomas may be a novel cutaneous diagnostic sign in adults with BAP1 TPDS," said the study.

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