{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T22:54:23Z","timestamp":1790117663992,"version":"4.0.1"},"reference-count":15,"publisher":"MDPI AG","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:p>Acral lentiginous melanoma (ALM) is a disease that is found on the palms, soles, and nail beds. Because these areas are not often examined during general medical examinations, the presence of ALM often goes unnoticed or the diagnosis is delayed. Research shows that the misdiagnosis of ALM is common, reported between 20% and 34%. We present three cases of ALM that were initially misdiagnosed and referred to the senior author (B.C.M.) in an effort to assess why misdiagnosis is common. The existing literature illuminates clinical pitfalls in diagnosing ALM. The differential diagnosis of many different podiatric skin and nail disorders should include ALM. Although making the correct diagnosis is essential, the prognosis is affected by the duration of the disease and level of invasiveness. Unfortunately, most of the reported misdiagnosed cases are of a later stage and worse prognosis. This review highlights that foot and ankle specialists should meet suspect lesions with a heightened index of suspicion and perform biopsy when acral nonhealing wounds and\/or lesions are nonresponsive to treatment.<\/jats:p>","DOI":"10.7547\/17-038","type":"journal-article","created":{"date-parts":[[2019,1,16]],"date-time":"2019-01-16T15:04:31Z","timestamp":1547651071000},"page":"166-171","source":"Crossref","is-referenced-by-count":9,"title":["The Misdiagnosis of Acral Lentiginous Melanoma: Three Case Presentations"],"prefix":"10.3390","volume":"109","author":[{"given":"Bryan C.","family":"Markinson","sequence":"first","affiliation":[{"name":"The Leni and Peter W. May Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jered M.","family":"Stowers","sequence":"additional","affiliation":[{"name":"New York College of Podiatric Medicine, New York, NY. Dr. Stowers is now with MedStar Washington Hospital Center and MedStar Georgetown University Hospital, Washington, DC. Dr. Black is now with Lenox Hill Hospital Northwell, New York, NY. Dr. Saccomanno is now with Hungtington Hospital at Northwell Health, Huntington, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Black","sequence":"additional","affiliation":[{"name":"New York College of Podiatric Medicine, New York, NY. Dr. Stowers is now with MedStar Washington Hospital Center and MedStar Georgetown University Hospital, Washington, DC. Dr. Black is now with Lenox Hill Hospital Northwell, New York, NY. Dr. Saccomanno is now with Hungtington Hospital at Northwell Health, Huntington, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosario","family":"Saccomanno","sequence":"additional","affiliation":[{"name":"New York College of Podiatric Medicine, New York, NY. Dr. Stowers is now with MedStar Washington Hospital Center and MedStar Georgetown University Hospital, Washington, DC. Dr. Black is now with Lenox Hill Hospital Northwell, New York, NY. Dr. Saccomanno is now with Hungtington Hospital at Northwell Health, Huntington, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garrett","family":"Desman","sequence":"additional","affiliation":[{"name":"Departments of Pathology and Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"i8750-7315-109-2-166-b01","series-title":"Key statistics for melanoma skin cancer","year":"2017","unstructured":"American Cancer Society: Key statistics for melanoma skin cancer. Available at: http:\/\/www.cancer.org\/cancer\/skincancer-melanoma\/detailedguide\/melanoma-skin-cancer-key-statistics. Accessed October 14, 2017."},{"key":"i8750-7315-109-2-166-b02","series-title":"Ann Surg Oncol","doi-asserted-by":"publisher","first-page":"3618","DOI":"10.1245\/s10434-013-3089-0","article-title":"Prognosis of acral melanoma: a series of 281 patients","volume":"20","author":"Bello \n              DM,","year":"2013","unstructured":"Bello \n              DM, \n            \n            \n              Chou \n              JF, \n            \n            \n              Panageas \n              KS, \n            \n            et al: \n          Prognosis of acral melanoma: a series of 281 patients. Ann Surg Oncol20: 3618, 2013.http:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000324060100038&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f310.1245\/s10434-013-3089-023838913"},{"key":"i8750-7315-109-2-166-b03","series-title":"Clin Dermatol","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1016\/j.clindermatol.2008.09.014","article-title":"Melanoma of the feet: misdiagnosed and misunderstood","volume":"27","author":"Albreski \n              D,","year":"2009","unstructured":"Albreski \n              D, \n            \n            \n              Sloan \n              SB: \n            \n          \n          Melanoma of the feet: misdiagnosed and misunderstood. Clin Dermatol27: 556, 2009.19880043http:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000271914700005&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f310.1016\/j.clindermatol.2008.09.014"},{"key":"i8750-7315-109-2-166-b04","series-title":"Arch Dermatol","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1001\/archdermatol.2008.609","article-title":"Acral lentiginous melanoma: incidence and survival patterns in the united states, 1986-2005","volume":"145","author":"Bradford \n              PT,","year":"2009","unstructured":"Bradford \n              PT, \n            \n            \n              Goldstein \n              AM, \n            \n            \n              McMaster \n              ML, \n            \n            et al: \n          Acral lentiginous melanoma: incidence and survival patterns in the united states, 1986-2005. Arch Dermatol145: 427, 2009.10.1001\/archdermatol.2008.60919380664"},{"key":"i8750-7315-109-2-166-b05","series-title":"Int Wound J","doi-asserted-by":"publisher","first-page":"1006","DOI":"10.1111\/iwj.12481","article-title":"Acral melanoma with satellitosis, disguised as a longstanding diabetic ulcer: a great mimicry","volume":"13","author":"Mansur \n              AT,","year":"2015","unstructured":"Mansur \n              AT, \n            \n            \n              Demirci \n              GT, \n            \n            \n              Ozel \n              O, \n            \n            et al: \n          Acral melanoma with satellitosis, disguised as a longstanding diabetic ulcer: a great mimicry. Int Wound J13: 1006, 2015.2640065710.1111\/iwj.12481http:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000387667600003&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3"},{"key":"i8750-7315-109-2-166-b06","series-title":"Br J Dermatol","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1111\/j.1365-2133.2009.09594.x","article-title":"Dermoscopic features of acral lentiginous melanoma in a large series of 110 cases in a white population","volume":"162","author":"Phan \n              A,","year":"2010","unstructured":"Phan \n              A, \n            \n            \n              Dalle \n              S, \n            \n            \n              Touzet \n              S, \n            \n            et al: \n          Dermoscopic features of acral lentiginous melanoma in a large series of 110 cases in a white population. Br J Dermatol162: 765, 2010.10.1111\/j.1365-2133.2009.09594.xhttp:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000275767500009&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3"},{"key":"i8750-7315-109-2-166-b07","series-title":"J Am Acad Dermatol","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1067\/mjd.2003.63","article-title":"Acral lentiginous melanoma mimicking benign disease: the Emory experience","volume":"48","author":"Soon \n              SL,","year":"2003","unstructured":"Soon \n              SL, \n            \n            \n              Solomon \n              AR\n              Jr, \n            \n            \n              Papadopoulos \n              D, \n            \n            et al: \n          Acral lentiginous melanoma mimicking benign disease: the Emory experience. J Am Acad Dermatol48: 183, 2003.1258238610.1067\/mjd.2003.63"},{"key":"i8750-7315-109-2-166-b08","series-title":"J Foot Ankle Res","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/1757-1146-3-25","article-title":"Clinical guidelines for the recognition of melanoma of the foot and nail unit","volume":"3","author":"Bristow \n              IR,","year":"2010","unstructured":"Bristow \n              IR, \n            \n            \n              de Berker \n              DAR, \n            \n            \n              Acland \n              KM, \n            \n            et al: \n          Clinical guidelines for the recognition of melanoma of the foot and nail unit. J Foot Ankle Res3: 25, 2010.http:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000296326900001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f310.1186\/1757-1146-3-2521040565"},{"key":"i8750-7315-109-2-166-b09","series-title":"Adv Exp Med Biol","first-page":"375","article-title":"Sun exposure and melanomas on sun-shielded and sun-exposed body areas","volume":"810","author":"Juzeniene \n              A,","year":"2014","unstructured":"Juzeniene \n              A, \n            \n            \n              Baturaite \n              Z, \n            \n            \n              Moan \n              J: \n            \n          \n          Sun exposure and melanomas on sun-shielded and sun-exposed body areas. Adv Exp Med Biol810: 375, 2014.25207377"},{"key":"i8750-7315-109-2-166-b10","series-title":"Dermatol Online J","doi-asserted-by":"publisher","first-page":"3","DOI":"10.5070\/D30S0514MH","article-title":"Acral lentiginous melanoma misdiagnosed as verruca plantaris: a case report","volume":"12","author":"Rosen \n              T:","year":"2006","unstructured":"Rosen \n              T: \n            \n          \n          Acral lentiginous melanoma misdiagnosed as verruca plantaris: a case report. Dermatol Online J12: 3, 2006.1708385810.5070\/D30S0514MH"},{"key":"i8750-7315-109-2-166-b11","series-title":"Med J Malaysia","first-page":"422","article-title":"Malignant melanoma of the foot in patients with diabetes mellitus: a trap for the unwary","volume":"67","author":"Hussin \n              P,","year":"2012","unstructured":"Hussin \n              P, \n            \n            \n              Loke \n              SC, \n            \n            \n              Noor \n              FM, \n            \n            et al: \n          Malignant melanoma of the foot in patients with diabetes mellitus: a trap for the unwary. Med J Malaysia67: 422, 2012.23082455"},{"key":"i8750-7315-109-2-166-b12","series-title":"J Am Podiatr Med Assoc","doi-asserted-by":"publisher","first-page":"189","DOI":"10.7547\/0003-0538-105.2.189","article-title":"Acral lentiginous melanoma of the foot misdiagnosed as a traumatic ulcer. A cautionary case","volume":"105","author":"Gumaste \n              P,","year":"2015","unstructured":"Gumaste \n              P, \n            \n            \n              Penn \n              L, \n            \n            \n              Cohen \n              N, \n            \n            et al: \n          Acral lentiginous melanoma of the foot misdiagnosed as a traumatic ulcer. A cautionary case. J Am Podiatr Med Assoc105: 189, 2015.25815661http:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000367674100014&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f310.7547\/0003-0538-105.2.189"},{"key":"i8750-7315-109-2-166-b13","series-title":"Int J Dermatol","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1111\/j.1365-4632.2004.02085.x","article-title":"Acral lentiginous melanoma misdiagnosed as tinea pedis: A case report","volume":"43","author":"Serarslan \n              G,","year":"2004","unstructured":"Serarslan \n              G, \n            \n            \n              Akcaly \n              C, \n            \n            \n              Atik \n              E: \n            \n          \n          Acral lentiginous melanoma misdiagnosed as tinea pedis: A case report. Int J Dermatol43: 37, 2004.10.1111\/j.1365-4632.2004.02085.x14693019"},{"key":"i8750-7315-109-2-166-b14","series-title":"J Biol Regul Homeost Agents","article-title":"Heel melanoma: the final result of wrong diagnostic and therapeutic approach in another Bulgarian patient. First documented case from the board of the \u201cadcrstr-association for dermatohistopathologic control, reevaluation and subsequent therapeutic recomme","volume":"29","author":"Chokoeva \n              AA,","year":"2015","unstructured":"Chokoeva \n              AA, \n            \n            \n              Tchernev \n              G, \n            \n            \n              Gianfaldoni \n              S, \n            \n            et al: \n          Heel melanoma: the final result of wrong diagnostic and therapeutic approach in another Bulgarian patient. First documented case from the board of the \u201cadcrstr-association for dermatohistopathologic control, reevaluation and subsequent therapeutic recomme. J Biol Regul Homeost Agents29(suppl):111,2015.26016978"},{"key":"i8750-7315-109-2-166-b15","series-title":"Arch Dermatol","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1001\/archderm.1972.01620070020007","article-title":"Diffuse and banded melanin pigmentation in nails","volume":"105","author":"Leyden \n              JJ,","year":"1972","unstructured":"Leyden \n              JJ, \n            \n            \n              Spott \n              DA, \n            \n            \n              Goldschmidt \n              H: \n            \n          \n          Diffuse and banded melanin pigmentation in nails. Arch Dermatol105: 548, 1972.501726410.1001\/archderm.1972.01620070020007"}],"container-title":["Journal of the American Podiatric Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/japmaonline.org\/view\/journals\/apms\/109\/2\/17-038.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/japma\/article-pdf\/109\/2\/166\/2457812\/17-038.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/109\/2\/17-038.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/109\/2\/17-038.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:17:38Z","timestamp":1783505858000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1930-8264\/109\/2\/166"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3]]},"references-count":15,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.7547\/17-038","relation":{},"ISSN":["8750-7315","1930-8264"],"issn-type":[{"value":"8750-7315","type":"print"},{"value":"1930-8264","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3]]}}}