Misdiagnosed, Mistreated and Delay Diagnosed Acral Melanoma: The Atypical Presentations

Background: Acral skin is the most common site of malignant melanoma in non-Caucasian population. Diagnosis in this anatomic site is often delayed because this area is not routinely examined by patients or primary physicians. Objective: To perform an earlier diagnosis underlining the importance of dermoscopy helping clinicians to differentiate this disease from the other lesions and biopsies will result in more timely diagnoses and improved survival. Methods: We present 6 case studies visited in our Department of Dermatology of Naples University between October 2010 and September 2012. Results: These lesions often mimic other entities like warts, calli, bacterial or fungal infections, foreign bodies, vascular lesions, blisters, melanocytic nevi, subungual hematomas, pyogenic granulomas, onychomycosis, keratoacanthomas, diabetic foot ulcers, traumatic lesions that can lead to misdiagnosis and mistreatment. Conclusions: Awareness of atypical presentations of acral melanoma may be important to decrease misdiagnosis rates and improve patient outcome.