I’ve had a dark line growing in my nail for 5 years now. I recently visited a dermatologist and discovered that it is melanoma in situ and the dermatologist would like to remove the whole nail. I asked many questions but unfortunately after the surgery I would be left without a nail. I’m wondering if there is a possibility to get replacement nail or even a prosthetic nail?
Unfortunately as the nail bed (the pink tissue under the fingernail) is very thin, a skin cancer of the nail bed may involve the underlying bone. Your first concern should be complete removal of the melanoma in situ.
Based on your history and pictures posted, the concern is that this is an "Acral melanoma" fortunately this is insitu melanoma. My personal concern is not cosmesis but appropriate treatment. Acral Melanoma has a great debate as to the appropriate margin for excision.
I would see an expert in melanoma and a plastic/hand surgeon and an oncologist expert in melanoma. This is because the nail bed an whether it extends to the nail MATRIX. A full biopsy of the lesion and based on the histopathology and cell characteristics a decision is made as to the most appropriate surgery. You may find such experts at UVA or EMORY in Atlanta where president Carter was treated.
I think you should consult plastic surgeon specialist and think of health and safety before appearance for now. This type is called subungual melanoma and may involve other structures around.
My advice would be not to let the dermatologist treat this. You should make an appointment with an ABPS certified surgeon that has the extra certificate for surgery of the hand. There should be plenty close to you. Like the other surgeons told you, the main concern is to have the appropriate treatment so you do not die from this problem and not to worry about the cosmetic effect at this time. Once you have had the appropriate treatment, then we worry about the cosmetic part. There are some prosthetic appliances but most people find them cumbersome and end up not wearing them. Your life is more important.