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Thursday 16 August 2007

Subcorneal hematoma

this 45-year-old patient, bricklayer, consulted for this asymptomatic black lesion on his right heel that he noticed one month ago;the patient did not practice any sports. He used to wear security shoes during his work time. He complained of the hard soles of his shoes.

Dermoscopy (x20) showed a brown light parallel ridge pattern.
The band-like pigmentation is seen on on the ridges of the skin markings. The whitish dots are regularly distributed on the ridges and represent the openings of eccrine ducts.
On the lower site of the lesion, there are many red dots (satellites) allowing to diagnose a subcorneal hematoma or "black heel"
A clue for the diagnosis would be also performing scratching with a blade, because the hematoma is very superficially located .
It is important to remind that the parallel ridge pattern is mainly observed in acrolentiginous melanoma.
The 4 pictures concern the same case of subcorneal hematoma.