Dermoscopy of subcorneal hematoma.
BACKGROUND
Subcorneal hematoma is a pigmented skin lesion usually occurring on palms or soles after a trauma or sport activity. Clinically, it may exhibit overlapping features with acral melanoma or acral melanocytic nevi, leading to unnecessary excision of this otherwise harmless skin lesion.


OBJECTIVE
The objective was to describe the dermoscopic features in a series of subcorneal hematomas.


METHODS
Dermoscopic images of 15 subcorneal hematomas were evaluated for the presence of different colors and dermoscopic structures.


RESULTS
In our series, a red-black hue was the most frequent color seen by dermoscopy (40% of the lesions) and a homogeneous pattern of pigmentation was the most frequent dermoscopic structure (53.3%). Remarkably, 40% of the lesions exhibited a parallel-ridge pattern that is usually found in early melanoma of palms and soles. In 46.7% of the lesions, red-black globules were additionally seen at the periphery as satellites disconnected from the lesion's body. Only two lesions showed either parallel-furrow or fibrillar pattern. A scratch test performed in four lesions, allowed complete or partial removal of the pigmentation.


CONCLUSIONS
Dermoscopic features of subcorneal hematomas may be similar to those observed in acral melanocytic lesions. Nevertheless, in most cases the correct diagnosis can be facilitated by the presence of a red-black homogeneous pigmentation, often combined with satellite globules. A positive scratch test may be considered as an additional diagnostic clue.
Zalaudek
Iris
I
Department of Dermatology, University of Graz, Graz, Austria.
Argenziano
Giuseppe
G
Soyer
H Peter
HP
Saurat
Jean-Hilaire
JH
Braun
Ralph P
RP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006406:Hematoma / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012871:Skin Diseases / Q000473:pathology*