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Dermoscopy of subcorneal hematoma
Iris Zalaudek1, Giuseppe Argenziano, H Peter Soyer
1Department of Dermatology, University of Graz, Graz, Austria.
Summary
Subcorneal hematomas on palms and soles can mimic melanoma. Dermoscopy reveals key features like red-black hues and homogeneous patterns, aiding diagnosis and preventing unnecessary surgery.
Area of Science:
- Dermatology
- Dermoscopy
- Dermatopathology
Background:
- Subcorneal hematoma is a common, benign skin lesion on palms/soles.
- It can clinically resemble acral melanoma or nevi.
- Misdiagnosis may lead to unnecessary surgical excision.
Purpose of the Study:
- To characterize the dermoscopic features of subcorneal hematomas.
- To differentiate subcorneal hematomas from concerning acral lesions.
Main Methods:
- Dermoscopic evaluation of 15 subcorneal hematomas.
- Analysis of colors and dermoscopic structures.
- Inclusion of scratch test in a subset of cases.
Main Results:
- Red-black hue (40%) and homogeneous pigmentation (53.3%) were most common.
- A concerning 40% showed a parallel-ridge pattern, typical of early melanoma.
- Satellite globules were observed in 46.7%; scratch test aided pigment removal.
Conclusions:
- Dermoscopic findings in subcorneal hematomas can overlap with acral melanocytic lesions.
- Red-black homogeneous pigmentation and satellite globules are key diagnostic clues.
- A positive scratch test can further support the diagnosis of subcorneal hematoma.
