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.
Bello DM, Chou JF, Panageas KS, et al: Prognosis of acral melanoma: a series of 281 patients. Ann Surg Oncol 20: 3618, 2013.
Albreski D, Sloan SB: Melanoma of the feet: misdiagnosed and misunderstood. Clin Dermatol 27: 556, 2009.
Bradford PT, Goldstein AM, McMaster ML, et al: Acral lentiginous melanoma: incidence and survival patterns in the united states, 1986-2005. Arch Dermatol 145: 427, 2009.
Mansur AT, Demirci GT, Ozel O, et al: Acral melanoma with satellitosis, disguised as a longstanding diabetic ulcer: a great mimicry. Int Wound J 13: 1006, 2015.
Phan A, Dalle S, Touzet S, et al: Dermoscopic features of acral lentiginous melanoma in a large series of 110 cases in a white population. Br J Dermatol 162: 765, 2010.
Soon SL, Solomon AR Jr, Papadopoulos D, et al: Acral lentiginous melanoma mimicking benign disease: the Emory experience. J Am Acad Dermatol 48: 183, 2003.
Bristow IR, de Berker DAR, Acland KM, et al: Clinical guidelines for the recognition of melanoma of the foot and nail unit. J Foot Ankle Res 3: 25, 2010.
Juzeniene A, Baturaite Z, Moan J: Sun exposure and melanomas on sun-shielded and sun-exposed body areas. Adv Exp Med Biol 810: 375, 2014.
Rosen T: Acral lentiginous melanoma misdiagnosed as verruca plantaris: a case report. Dermatol Online J 12: 3, 2006.
Hussin P, Loke SC, Noor FM, et al: Malignant melanoma of the foot in patients with diabetes mellitus: a trap for the unwary. Med J Malaysia 67: 422, 2012.
Gumaste P, Penn L, Cohen N, et al: Acral lentiginous melanoma of the foot misdiagnosed as a traumatic ulcer. A cautionary case. J Am Podiatr Med Assoc 105: 189, 2015.
Serarslan G, Akcaly C, Atik E: Acral lentiginous melanoma misdiagnosed as tinea pedis: A case report. Int J Dermatol 43: 37, 2004.
Chokoeva AA, Tchernev G, Gianfaldoni S, et al: Heel melanoma: the final result of wrong diagnostic and therapeutic approach in another Bulgarian patient. First documented case from the board of the “adcrstr-association for dermatohistopathologic control, reevaluation and subsequent therapeutic recomme. J Biol Regul Homeost Agents 29 (suppl):111, 2015.
Leyden JJ, Spott DA, Goldschmidt H: Diffuse and banded melanin pigmentation in nails. Arch Dermatol 105: 548, 1972.
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.