Funding sources None.
CLINICAL AND LABORATORY INVESTIGATIONS
Dermoscopy of subungual haemorrhage: its usefulness in differential diagnosis from nail-unit melanoma
Article first published online: 5 JUN 2013
© 2013 The Authors. BJD © 2013 British Association of Dermatologists
British Journal of Dermatology
Volume 168, Issue 6, pages 1224–1229, June 2013
How to Cite
Mun, J.-H., Kim, G.-W., Jwa, S.-W., Song, M., Kim, H.-S., Ko, H.-C., Kim, B.-S. and Kim, M.-B. (2013), Dermoscopy of subungual haemorrhage: its usefulness in differential diagnosis from nail-unit melanoma. British Journal of Dermatology, 168: 1224–1229. doi: 10.1111/bjd.12209
Conflicts of interest None declared.
J.-H.M. and G.-W.K. contributed equally to this work.
- Issue published online: 5 JUN 2013
- Article first published online: 5 JUN 2013
- Accepted manuscript online: 10 JAN 2013 12:40AM EST
- Accepted for publication 31 December 2012
Vol. 169, Issue 3, 727, Article first published online: 30 AUG 2013
Background Subungual haemorrhages are characterized by well-circumscribed dots or blotches with a red to red–black pigmentation, but some cases can be difficult to distinguish from subungual melanoma by the naked eye alone. Dermoscopy has proven to be a useful, noninvasive tool in the diagnosis of pigmented lesions in the nail; however, few dermoscopic studies of subungual haemorrhages have been reported.
Objectives To investigate characteristic dermoscopic patterns of subungual haemorrhages, and to find distinctive features that can differentiate them from nail-unit melanomas.
Methods Patients with a confirmed diagnosis of either subungual haemorrhage or nail-unit melanoma at a tertiary university hospital were included in the study. Clinical features and dermoscopic patterns were evaluated.
Results Sixty-four patients with a total of 90 lesions of subungual haemorrhage were enrolled in the study. The majority of cases (84%) showed combinations of more than one colour, while 16% had only one colour. The most common colour of the subungual haemorrhages was purple–black, in 37% of cases. A homogeneous pattern was observed in 92% of cases, globular patterns in 42% and streaks in 39%. Peripheral fading and periungual haemorrhages were found in 54% and 22% of cases, respectively. Destruction or dystrophy of the nail plate was observed in 16% of cases. In the 16 cases of nail-unit melanomas, Hutchinson sign, longitudinal irregular bands or lines, triangular shape of bands, vascular pattern, and ulcerations were found in 100%, 81%, 25%, 6% and 81% of cases, respectively. In contrast, these features were not found in subungual haemorrhages.
Conclusions Dermoscopy provides valuable information for the diagnosis of subungual haemorrhage and aids in the differential diagnosis from nail-unit melanoma.