title: Acral melanoma of the hallux.
abstract: OBJECTIVE
  A case of misdiagnosed acral melanoma of the hallux and its diagnostic challenge are herein presented. Acral melanoma is insidious and subtle. A methodic approach to any suspicious lesions is mandatory. A case of misdiagnosed acral melanoma of the hallux is herein reported in a 66-year-old healthy man. Suggestions concerning similar non-healing lesions are herein presented.
  
  
  METHODS
  It was firstly clinically diagnosed and treated as a micosis at another centre. The absence of any amelioration after three years pushed us to perform a biopsy.
  
  
  RESULTS
  An acral melanoma was revealed, treated by amputation.
  
  
  CONCLUSIONS
  In case of a non-healing ulcer of the lower extremities, melanoma should be taken into consideration. Even in absence of any suggestive risk factors or clear signs of melanoma, the lack of any improvement after treatment should raise doubts about diagnosis. In particular, biopsy is advisable as a first attempt to guide the management.
authors: Department of Plastic and Reconstructive Surgery, Catholic University of the Sacred Heart, School of Medicine, Rome, Italy. marco.dettorre@hotmail.it.
authors: S
authors: S
authors: Gentileschi
authors: M
authors: M
authors: D'Ettorre
authors: D
authors: D
authors: Tambasco
authors: R
authors: R
authors: Bracaglia
authors: A
authors: A
authors: Santoro
mesh_terms: D000368:Aged; D001706:Biopsy; D003951:Diagnostic Errors; D006214:Hallux / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery