Acral melanoma mimicking subungual hematoma

An 86-year old woman presented to our clinic with a partial black streaklike pigmentation on her right thumb nail, which extended from the distal toward the proximal nail plate. At first glance, a subungual hematoma was considered. However, turning the hand around revealed a large, irregular brown pigmentation on the glabrous skin of the thumb, which reached under the free edge of the nail (Fig 1).