eISSN: 2299-0046
ISSN: 1642-395X
Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii
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SCImago Journal & Country Rank
4/2020
vol. 37
 
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abstract:
Original paper

Dermoscopic diagnosis of subungual hematoma: new observations

Mahmut Sami Metin
1
,
Ömer Faruk Elmas
2

1.
Department of Dermatology and Venereology, Batman Medical Park Hospital, Batman, Turkey
2.
Department of Dermatology and Venereology, Faculty of Medicine, Ahi Evran University, Kırşehir, Turkey
Adv Dermatol Allergol 2020; XXXVII (4): 490–494
Online publish date: 2020/09/02
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Introduction
There are very few studies focusing on the dermoscopic features of subungual hematoma which is one of the major imitators of subungual melanoma.

Aim
To identify the dermoscopic findings of subungual hematoma, which will facilitate the diagnostic process by reducing the use of more invasive diagnostic methods like nail avulsion or biopsy.

Material and methods
In this study, clinical and dermoscopic findings of the cases were reviewed. The diagnosis of subungual hematoma was confirmed by observing progression of the colour change to the distal edge of the nail plate in all the cases.

Results
A total of 47 subungual hematomas were enrolled in the study. The most common colour was purple-black (53%). Blue-white colour was observed in 12 (26%) lesions. 9 (19%) lesions showed granular leukonychia. All of the lesions had a homogenous pattern. In 25 (53%) lesions, a globular pattern was observed. 14 (30%) lesions showed a streaks pattern. Peripheral fading and periungual haemorrhage were present in 14 (30%) and 9 (9%) lesions, respectively.

Conclusions
We detected two new findings which have not been described previously for subungual hematoma: the first one is “blue-white colour” which is known as an important clue to melanoma. The second one is granular leukonychia localized on the hematoma. We suggest that in any case of the nail discoloration, a thorough dermoscopic examination should be performed. Moreover, progression of the colour change to the distal edge should be observed to ensure that a possible melanoma is not overlooked.

keywords:

dermoscopy, hematoma, subungual

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