Melanonychia striata longitudinalis. incident light microscopy: Melanonychia striata through melanocytic nevus on the index finger in a 19-year-old woman. fine-grained longitudinal brown pigmentation below the nail plate. normal nail fold capillaries. distinct pigmentation of the cuticles.
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).
Melanonychia striata longitudinalis (course): Initial findings in 2006, control findings 3 years later; the brown longitudinal stripe, persisting since about 2004, has almost completely receded within a period of 3 years except for a discrete residual pigmentation (arrow).
Hematoma, nail hematoma: growing nail hematoma . left initial situation, right 8 weeks later. note: the nail matrix shows no discoloration at the cutting edge (marked by arrows)!
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.
Pseudo-Hutchinson, sign (hematoma). hemosiderotic pigmentation of the nail fold. age-related nail (longitudinal stripes) with fine spiltter hemorrhages.
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.
Melanoma, malignant, acrolentiginous, subungual and paraungual, black pigmented tumor in the fingernail area, advanced stage with destruction of the nail.
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.
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