title: Clinical presentation of acral lentiginous melanoma: a descriptive study.
abstract: OBJECTIVE
  Acral lentiginous melanomas -the melanomas most commonly found on the distal portions of the limbs- have usually reached more advanced stages than other types of melanoma when diagnosed. Our aim was to describe the clinical presentation of these tumors.
  
  
  METHODS
  Retrospective, descriptive, observational study of cases recorded in the database of the Instituto Valenciano de Oncología. In telephone interviews the patients answered a questionnaire on the presenting features of the lesion, on the presence of signs and symptoms included in the Glasgow 7-point checklist and the ABCDEs of melanoma, and on diagnostic delay attributable to patient or physician.
  
  
  RESULTS
  In the interviews with the 23 patients who responded to the questionnaire, we detected a diagnostic delay of more than 1 year attributable to the patient (delay in seeking care) in 30.4% of the cases. Diagnostic delay of more than 1 year attributable to the physician (failure to suspect the diagnosis) was identified in 20%. The most frequent reasons for consulting a physician about a lesion were changes in size, changes in color, bleeding, or failure to heal. In 20% of the cases the evaluating physician did not order histology for over a year.
  
  
  CONCLUSIONS
  Diagnostic delay is a significant problem in acral lentiginous melanoma and may be attributable either to patients or to physicians' failure to recognize warning signs. Melanoma prevention campaigns should place more emphasis on the possibility of melanomas appearing on the palms and, particularly, on the soles.
authors.affiliation: Servicio de Dermatología, Valencia, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Pereda
authors.forename: V
authors.initials: V
authors.lastname: Traves
authors.forename: C
authors.initials: C
authors.lastname: Requena
authors.forename: C
authors.initials: C
authors.lastname: Serra-Guillén
authors.forename: B
authors.initials: B
authors.lastname: Llombart
authors.forename: O
authors.initials: O
authors.lastname: Sanmartín
authors.forename: C
authors.initials: C
authors.lastname: Guillén
authors.forename: E
authors.initials: E
authors.lastname: Nagore
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005528:Foot; D006225:Hand; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology*; D000096142:Cutaneous Malignant Melanoma