title: Multiple primary acral melanomas in two young caucasian patients.
abstract: BACKGROUND
  Acral melanoma (AM) is still one of the most poorly studied melanomas. It generally presents beyond the fifth decade of life and usually is a BRAF wild-type melanoma.
  
  
  OBJECTIVE
  To report the first cases of multiple primary AM in Caucasians.
  
  
  METHODS
  Clinical, dermoscopic, pathological and molecular profiles.
  
  
  RESULTS
  A healthy 34- year-old male presented an in situ subungual melanoma on his finger, and 22 months later a fast-growing nodular melanoma appeared in an existing nevus on the sole. Both melanomas carried the V600E BRAF mutation. A 19-year-old female patient presented 2 in situ melanomas on different parts of her left foot within a 6-year period of time. The patients have neither familiar melanoma nor germline mutations in CDKN2A/CDK4 genes.
  
  
  CONCLUSIONS
  Multiple AM in Caucasians is very rare. BRAF mutations are possible, especially in a high-risk set of patients with multiple nevi. Specific acral examination must be recommended since AM still suffers delayed detection.
authors.affiliation: Melanoma Unit, Dermatology Department, Hospital Clínic of Barcelona, Barcelona, Spain.
authors.forename: Goretti
authors.initials: G
authors.lastname: Lacruz
authors.forename: Isabel
authors.initials: I
authors.lastname: Cárdenas
authors.forename: Cristina
authors.initials: C
authors.lastname: Carrera
authors.forename: Alba
authors.initials: A
authors.lastname: Díaz
authors.forename: Joan Anton
authors.initials: JA
authors.lastname: Puig-Butillè
authors.forename: Celia
authors.initials: C
authors.lastname: Badenas
authors.forename: Josep
authors.initials: J
authors.lastname: Malvehy
authors.forename: Susana
authors.initials: S
authors.lastname: Puig
mesh_terms: D000328:Adult; D051358:Cyclin-Dependent Kinase 4 / Q000235:genetics; D005260:Female; D005385:Fingers; D005528:Foot; D005534:Foot Diseases / Q000235:genetics / Q000473:pathology*; D019942:Genes, p16; D006801:Humans; D008297:Male; D008545:Melanoma / Q000235:genetics / Q000473:pathology*; D016609:Neoplasms, Second Primary / Q000235:genetics / Q000473:pathology*; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics; D012878:Skin Neoplasms / Q000235:genetics / Q000473:pathology*; D044465:White People; D055815:Young Adult
chemical_list: C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf; D051358:Cyclin-Dependent Kinase 4