What is the cause of a black line in the middle of the nail?

It may be caused by a bulge in the central part of the nail that separates the nail plate from the nail bed, which can lead to bleeding or infection under the nail, and these bleeding or infected foreign bodies remain under the nail as black lines. Some tumours that occur directly under the nail, such as benign nail nevi or malignant nail melanoma, can also produce melanin directly, resulting in a black line under the nail.