<p>This patient was referred with nail discolouration. As is often the case with nails there had been no history of trauma. What are the key dermoscopic features and what is the diagnosis?</p>
<p>There is no involvement of the nail fold, and there is sparing of the proximal nail.</p>
<p>There are multiple colours (red, brown, yellow), a curved margin (black arrow) and red clods (white circle).</p>
<p>The diagnosis is in keeping with a <strong>subungual haematoma.</strong></p>
<p><strong>Features of nail haemorrhage can include:</strong></p>
<p>- Proximal sparing (either initially, or, over time as the blood grows out with the nail)<br>- Curved edge<br>- Jagged lines<br>- Multiple colours<br>- Distinct clods, sometimes separate to the main affected area </p>
<p><strong>Features of nail melanoma can include:</strong><br></p>
<p>- Linear longitudinal band with no proximal sparing<br>- The line gets wider over time and can be broader proximally<br>- Pigment affecting the nail fold<br></p>
<p>Occasionally melanoma can present as nail destruction.</p>
<p>For more information refer to the <strong><a href="http://www.pcds.org.uk/clinical-guidance/nails">nail chapter</a>. </strong></p>
