hematoma, nail hematoma. blue-blackish, sharply defined pigmentation (here of the big toe nail) due to a previous traumatic event. no distal stripy nail discoloration. the absence of distal stripy nail changes excludes the important differential diagnoses "subungual malignant melanoma" and "subungual melanocytic nevus".
Circumscribed scleroderma (type Atrophodermia idiopathica et progressiva ): since about 2-3 years first appearing, since then size progressive, large brown, little indurated, non-symptomatic spots in the area of the trunk in a 23-year-old female patient.
Urticaria pigmentosa: General view: about 0.5-1.0 cm large, disseminated, roundish, brownish-red spots. Only when rubbed, the spots redden more strongly with accompanying itching. Increased reddening and itching even in warm showers or baths.
acrodermatitis chronica atrophicans. 57-year-old female patient. skin changes existing for five years now, clearly increasing for half a year, discoloured red-blueish in cold weather. large, blurredly limited, symmetrical erythema (completely anaemic). the skin surface is wrinkled in the breast area (atrophic), otherwise smooth. some splatter-like white discolorations.
Incontinentia pigmenti, Bloch-Sulzberger type: a few weeks old girl with flat and streaky, inflammatory, in places hardly noticeable blistery skin changes.
Addison's disease: the palms of the previously described patient. pigmentation of the palm lines as well as the finger wrinkles. hyperpigmentation at traumatized areas typical for Addison's disease (here: calluses)
Ecchymosis. circumscribed purple-shaped hemorrhage on the chin of a 14-year-old boy. the lesion is caused by the creation of a negative pressure (suction of a glass) on the chin.
Nail hematoma: sharply limited brownish discoloration of the nail; no streaky distal pigmentation of the nail (important differential diagnostic distinction to a malignant melanoma).
Mixed connective tissue disease. hyperkeratoticnail folds with elongated capillaries and focal haemorrhages. Note the splatter-like scars on the back of the fingers as well as the expression of focal, now healed scarred, cutaneous vascular occlusions.
Melanonychia striata longitudinalis: completelysymptomless brown-black longitudinal pigmentation of the nail plate. on frontal view the thickness of the pigment strip becomes visible. the white-crumbly structure of the nail indicates an additional nail mycosis.
Dermatitis chronic actinic. detail enlargement: Disseminated, scratched papules and nodules as well as blurred, large-area, red, sharply itching fine-lamellar scaling spots and plaques in the face of a 51-year-old female patient with atopic eczema existing since birth.
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