Melanonychia longitudinalis: Wide discrete brown longitudinal discoloration of the thumbnail; the so-called Hutchionson sign (pigmentation of the nail fold in extension of the melanonychia strip) not detectable.
Psoriasis of the nails: periungual, chronic stationary (little exudative) psoriasis with psoriatic onychopathy, here covered with an artificial nail. hyperkeratotic eponychium.
Nail hematoma: since exactly 6 weeks existing (trauma reminding), sharply forward limited blue-black discoloration of the big toe nail with discoloration of the epinychium; the sharp, here diagonally running dividing line without distal stripe-shaped discoloration of the nail matrix excludes a malignant melanoma!
Nail hematoma: since exactly 6 weeks existing (trauma recallable), sharply forward limited 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 fresher bleeding
Acute paronychia: blistery, circumferential, painfully throbbing paronychia (bulla repens) that has been present for a few days, caused by poygenic cocci.
Mlelanom malignes acrolentiginous: Subungual malignant melanoma. Characteristic is the stripy growth through the entire length of the nail. The arrow marks the so-called Hutchinson sign.
Melanoma, malignant, acrolentiginous, subungual and paraungual, black pigmented tumor in the fingernail area, advanced stage with destruction of the nail.
Melanonychia striata longitudinalis: DD- subungual malignant melanoma; look for the discoloration of the cuticle (so-called Hutchinson's sign), as an indication of involvement of the nail root
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.
DD: Nail hematoma - here Melanonychia longitudinalis: Typical finding of a melanocytic pigmentation of the nail. Melanon grows in stripes, starting at the site of pigment formation (here the nail root is not visible) to the front. This finding is not observed in a nail hematoma. Note: the nail matrix shows a dark discoloration at the front edge of the cut (pigment is embedded in the nail matrix).
Lichen planus (classic type). increasing findings since several months. onychodystrophy with roughening of the nail plate, longitudinal ripples and pitting.
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