Nail hematoma: sharply distally limited discoloration of the big toe nail. nail matrix at the distal cutting edge unchanged. no longitudinal striation of the nail.
blue nevus. blue-black, coarse, sharply defined, calotte-shaped node with a smooth, like polished, shiny surface. in addition, hairs run through the node. follicle ostia funnel-like indented. especially the detection of hairs in the node area speaks against malignancy (DD: nodular malignant melanoma), because the tumor growth does not infiltrate and destroy the hair follicles.
Melanoma malignes (Lentigo maligna melanoma): a brown, now black raised area (plaque) that has existed for years with imperceptible growth; no subjective complaints.
Melanoma malignes, type SSM: 2.8x 1.8 cm large black plaque with a nodular part on the back; small satellite; inlet close up and reflected light microscopic image.
melanoma malignes "type primary nodular melanoma": advanced nodular malignant melanoma. black nodule known for several years with increasing thickness growth. in the last half year faster growth. repeated wetting and bleeding of the surface.
Melanonychia longitudinalis: stripy (melanotic) nail pigmentation caused by a (still benign) pigment nevus localized in the (not visible) nail matrix. The anterior incision edge of the nail plate is pigment-bearing (marked with an arrow). An initial malignant melanoma must be excluded.
Lentigo-maligna melanoma (close-up): a slow-growing, first brown, then black, sharply defined spot, known for several years, which is now palpable as a sublimity. close-up
DD: acrolentiginous malignant melanoma: here: Melanonychia longitudinalis:stripy (melanotic) nail pigmentation caused by a (still benign) pigment nevus localized in the (not visible) nail matrix. The anterior cut edge of the nail plate is pigment-bearing (marked with an arrow). An initial malignant melanomacan be excluded histologically with certainty.
DD. acrolentiginous malignant melanoma: in this case nail hematoma . 6 weeks old (trauma recall), sharp blue-black discoloration of the big toe nail (marked by arrows and line) with discoloration of the epinychium (circle). arrow (right) indicates a streaky (still red) apparently fresh bleeding.
Melanoma, malignant, nodular, " always present", solitary, asymptomatic, growing for more than a year, coarse, largely symmetrical node with atropically shiny surface,
Melanoma, malignant, nodular. Malignant melanoma of the primary nodular type. Over the last few months, surface and thickness growth. "Been wet before." Dark brown-black, smooth-surfaced (like polished) lumps. Arrow-marked satellite metastases shimmering bluish through. Encircling a capillary angioma.
Melanoma, malignant, superficially spreading, since 2 years existing, slowly progressing in size, pectoralized on the right side, measuring 1.7 x 1.3 cm, inhomogeneously pigmented, sharply but irregularly limited, black-greyish to bluish plaque.
Melanoma, malignant, superficially spreading. reflected light microscopy: Inhomogeneous, black-greyish-bluish pigmented, sharp but irregularly defined plaque with widened reticular ridges and irregular netting meshes. The outer line with streaky, bud-like extensions is characteristic of malignancy.
tinea unguium: black dyschromia of the nail plate localized at the left big toe of a 52-year-old man, increasing for more than one year. border zone to the healthy nail plate marked proximally by a horizontal arrow. cuticle not discolored (vertical arrows: speaks against a melanocytic tumor). nail plate itself is discolored (see anterior incision margin marked by a star). Trichophyton rubrum and Aspergillus spp. have been culturally proven.
Thrombangiitis obliterans. 52-year-old patient with decades of nicotine abuse. 6 months of acrozynosis (even more severe in cool surroundings) and mummified toe cap necrosis with osteolysis.
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