A 18-year-old man consulted for a pigmented lesion on his left heel.

Dermoscopy revealed a parallel ridge pattern and the presence of aggregated black globules, noticeably visible at the border of the lesion : this unique dermoscopic feature named "pebbles on the ridges" is typical of a subcorneal haemorrhage (or subcorcorneal hematoma, black heel).

Parallel ridge pattern

A 27-year-old woman consulted for this pigmented lesion on the sole of her left foot present for 2 months. Dermoscopy revealed a parallel ridge pattern and the presence of aggregated black globules, well seen at the border of the lesion (red circle): this unique dermoscopic feature named "pebbles on the ridges" is typical of a subcorneal haemorrhage (or subcorcorneal hematoma, black heel).

Pebbles on the ridges

Subcorneal haemorrhage (*) is a differential diagnosis of acral melanoma. This patient who was a squash player consulted for this pigmentation of his anterior right foot. Dermoscopy revealed multiple brown pebble-like droplets on the ridges. This is a unique feature in dermoscopy named "pebbles on the ridges"
Brown sattelites (circled on the picture) were a helpful clue for the diagnosis. Superfical shaving of the corneal layer with a blade confirmed the diagnosis.
* subcorneal hematoma and black heel are synonyms.