title: Acral lentiginous melanoma of the foot and ankle: A case series and review of the literature.
abstract: BACKGROUND
  Acral lentiginous melanoma (ALM) is an uncommon, cutaneous malignant tumour which may arise on the foot. Its relative rarity, atypical appearance and late presentation frequently serve as poor prognostic indicators.
  
  
  METHODS
  At a tertiary skin tumour centre, a retrospective review was undertaken of all patients diagnosed with the tumour at the level of ankle or below.
  
  
  RESULTS
  Over a six year period, 27 cases (20 female, 7 male) were identified with positive histology confirming the disease. The age ranged from 35-96 years of age (mean 62.7 years). The majority of the cohort were white (59%) with plantar lesions (62%). 33% of patients were initially were diagnosed incorrectly. The average time taken from the point of recognition, by the patient, to the lesion being correctly diagnosed was around 13.5 months.
  
  
  CONCLUSIONS
  Earlier diagnosis of ALM requires education at both a patient and practitioner level.
authors.affiliation: School of Health Sciences, University of Southampton, UK. ib@soton.ac.uk.
authors.forename: Ivan R
authors.initials: IR
authors.lastname: Bristow
authors.forename: Katharine
authors.initials: K
authors.lastname: Acland