[The acrolentiginous melanoma: how to recognise and when to refer?].
In Caucasians, the acrolentiginous melanoma is a rare type of melanoma and may appear on hands, feet and subungually. It has the worst prognosis of all melanomas, due to the high rate of misdiagnosis. In 30% of the patients, it presents amelanotic and may resemble for example a common wart, paronychia, ulceration or mycosis. We present 4 patients, aged 48 years and older, in whom an acrolentiginous melanoma was contemplated. One of the lesions was highly suspected of a subungual acrolentiginous melanoma, because of the presence of Hutchinson's sign. Another lesion presented amelanotic and mimicked a foot ulcer. Acrolentiginous melanoma should be considered in case of uncertain diagnosis, delay in healing, enlargement of the lesion and when a pigmented lesion is larger than 7 mm. In these situations, early histopathological examination should be performed.
Maastricht Universitair Medisch Centrum, afd. Dermatologie, Maastricht, the Netherlands. l.wouters@student.maastrichtuniversity.nl
Loes T C M
LT
Wouters
Monique R T M
MR
Thissen
D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D057210:Delayed Diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis*; D008875:Middle Aged; D009260:Nail Diseases / Q000175:diagnosis*; D012878:Skin Neoplasms / Q000175:diagnosis*