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Dermatology Research and Practice
Volume 2009, Article ID 278040, 4 pages
Case Report

Simple Diagnostic Tests for Subungual Pigmentation

1Department of Family Medicine, University of Colorado, 3936 Main Street no. 202 Westminster, Denver, CO 80031, USA
212 Meadow Street, Williamstown, MA 01267, USA

Received 19 November 2009; Accepted 18 December 2009

Academic Editor: Robert Baran

Copyright © 2009 Shardul Poudyal and David J. Elpern. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Subungual pigmentation can have benign and malignant etiologies. A common and important differential diagnosis is between subungual hematoma and subungual acrolentiginous melanoma. We have introduced Dr. Eckert Haneke's technique and our Hydrogen Peroxide modification for distinguishing these entities clinically. Dr. Haneke's technique uses the hemocult reaction to detect hematoma from the specimen, while our modification uses Hydrogen Peroxide to clear the hematoma and make the decision clinically. Both are minimally invasive techniques which can be performed without pain. Often these procedures spare the patient an unnecessary tissue biopsy with its morbidity and discomfort. Importantly, they reassure the patient that he or she has a benign disorder.