title: [A Case of Delayed Dia-gnosis of Acral Lentiginous Melanoma].
abstract: BACKGROUND
  Melanoma is a malignant skin disease. The tumor development is caused by an uncontrollable proliferation of melanocytes. The most common occurrence is on the skin, but melanoma may also develop on the mucous membrane, meninges, and eyes. Some melanomas develop from melanocytic nevus. Acral lentiginous melanoma occurs on palms, feet, fingers and under nails, and is the most common type of melanoma for phototype VI. The most important factor for successful treatment of malignant melanoma is an early detection, excision of the primary tumor and histological staging. Surgical treatment of an early-stage melanoma is a key to successful therapy; however, many patients (mostly men) do not seek medical attention before it istoo late.
  
  
  METHODS
  This case study presents a 59-year-old patient, who suffers from white coat syndrome and whose finger was amputated for alleged gangrene. Subsequently, brownish black nodules appeared across his arm. Histological examination proved metastases of malignant melanoma. It was only at this phase, when the patient admitted a nevus at the tip of his amputated finger, from which ulceration and gangrene gradually emerged.
  
  
  CONCLUSIONS
  This case demonstrates a combination of multiple unfavorable factors, which led to delayed diagnosis and therapy.
authors.forename: M
authors.initials: M
authors.lastname: Gottvaldová
authors.forename: H
authors.initials: H
authors.lastname: Jedličková
authors.forename: A
authors.initials: A
authors.lastname: Poprach
authors.forename: V
authors.initials: V
authors.lastname: Vašků
mesh_terms: D057210:Delayed Diagnosis / Q000009:adverse effects*; D003951:Diagnostic Errors; D005734:Gangrene / Q000209:etiology*; D006801:Humans; D018327:Hutchinson's Melanotic Freckle / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012878:Skin Neoplasms / Q000175:diagnosis*