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Acral Melanoma Simulating Warts: Dermoscopic Clues to Prevent Missing a Melanoma

DALMAU, JOAN, MD*; ABELLANEDA, CRISTINA, MD; PUIG, SUSANA, MD; ZABALLOS, PEDRO, MD; MALVEHY, JOSEP, MD

DERMOSCOPY
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BACKGROUND Acral melanoma may adopt a variety of clinical characteristics simulating other tumors, ulcers, hemorrhage, or infections. In the Caucasian population health care providers often misdiagnose acral melanoma, and this is the cause of inadequate treatments. Clinical and dermoscopic clues can be easily recognized, which help to prevent missing a melanoma.

OBJECTIVES To study the clinical and dermoscopic findings in three cases of acral melanoma simulating warts that had been treated by dermatologists with curettage and cryotherapy.

MATERIAL AND METHODS Clinical and dermoscopic study of the tumors and review of the most frequent simulators of acral melanoma reported in the literature.

RESULTS In all three tumors, hyperkeratosis and the lack of specific pigmentation were observed. The parallel ridge pattern, revealed by dermoscopic examination, precipitated the recognition of acral melanoma.

CONCLUSION In these cases that presented atypical characteristics of acral lesions, therefore challenging the diagnostic process, dermoscopic examination helped to confirm an accurate diagnosis of acral melanoma.

*Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

Melanoma Unit, Dermatology Department, Hospital Clinic, IDIBAPS, Barcelona, Spain

Department of Dermatology, Hospital Santa Tecla, Tarragona, Spain

Address correspondence and reprint requests to: Dr Joan Dalmau Arias, Department of Dermatology, Hospital Santa Creu i Sant Pau, Sant Antoni Maria Claret 167, 08025 Barcelona, Spain, or e-mail: jdalmau@hsp.santpau.es.

This study was supported in part by grants from Fondo de Investigaciones Sanitarias and National Cancer Institute.

Acknowledgments The authors thank the staff members of the Dermatology Department and the members of the Melanoma Unit of the Hospital Clinic of Barcelona (J. Malvehy, S. Puig, T. Castel, A. Vilalta, A. Campo, J. Palou, C. Conill, M. Sanchez, R. Rull, R. Molina, S. Vidal, R. Vilella, R. Gallego, Y. Garcia, and C. Badenas) for their collaboration in the diagnostic and therapeutic management of the patients included in the study.

© 2006 by the American Society for Dermatologic Surgery, Inc.
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