Melanoma of the hands or feet can be considerably more deadly than melanoma in other locations. It also is more common in people with darker skin. It is the most common type of melanoma in black and Asian populations. They are often deeper at diagnosis and can involve the nail apparatus. As a result, the photo submitted by this patient was very concerning. However on close inspection you can see the uniformity of pigment and the sharp smooth contours which are not typical of melanoma. The patient was instructed to come to the office where the lesion was opened with a scalpel and revealed to be a hematoma.