haematoma, nail haematoma. nail alteration after slight crush trauma. striped, red and blue-black spots (splinter hemorrhages). since red and black shades are present at the same time, this finding speaks against a melanotic pigmentation.
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!
DD: Melanoma malignes acrolentiginous: here: complicating onychomycosis with bleeding due to mold infestation; the inlet points proximally, a normally colored nail area; no Hutchinson phenomenon.
Erythronychia, localized longitudinal detail magnified by reflected light microscopy; solitary, painless, red longitudinal striation of the nail plate with slight, V-shaped retraction and several splinter hemorrhages.
Nail hematoma: Apparently caused by repetitive trauma (probably triggered by a trauma from frontal trauma, e.g. during a football match), transverse bleeding, the growing nail area is normally stained.
Erythronychia, localized longitudinal. idiopathic, solitary, painless, red longitudinal striation of the nail plate with low-grade, V-shaped retraction and splinter hemorrhaging. The clinical picture is diagnostically conclusive.
half and half nail: zonal, sharply bordered white coloration of the proximal and brown coloration of the distal nail plate. slight acrocyanosis. no underlying disease remembered. known is a polyneuropathy
Illustration was kindly provided by Dr. med. H. Luther/Essen.
Melanonychia striata longitudinalis: approx. 0.2 cm wide, dark brown strip of the nail. nail fold very discreetly affected (see inlet). only 1 fingernail is affected. a clinical control (photo documentation) with measurement of the width of the pigment strip is recommended.
hematoma, nail hematoma. blue-blackish, sharply defined pigmentation (here of the big toe nail) due to a previous traumatic event. no distal stripy nail discoloration. the absence of distal stripy nail changes excludes the important differential diagnoses "subungual malignant melanoma" and "subungual melanocytic nevus".
Nail hematoma: sharply limited brownish discoloration of the nail; no streaky distal pigmentation of the nail (important differential diagnostic distinction to a malignant melanoma).
Melanonychia striata longitudinalis (detailed picture): approx. 0.4 cm wide, dark brown strip of the nail; nail fold with distinct paraungual rim; especially malignant melanoma of the nail root.
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
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