Amelanotic acral melanoma misdiagnosed as verruca plantaris

Abstract

We report a case of amelanotic acral melanoma in a 42-year-old Chinese woman. Ten months previously the patient found a 2-cm asymmetric erythematous macular plaque on her left sole. The lesion was diagnosed as verruca plantaris by every physician the patient consulted. One month ago, an enlarged lymph node was detected in the left groin, which biopsy reported as metastatic melanoma. Dermoscopy suggested verruca plantaris, and positron emission tomography (PET) revealed increased glucose metabolism in the macular plaque. Finally, biopsy of the plaque revealed amelanotic melanoma. Misdiagnosis and diagnostic delay are usually associated with poorer patient outcomes. Awareness of atypical presentations of acral melanoma is thus important for decreasing misdiagnosis rates and improving patient outcomes.

Amelanotic melanoma masquerading as a plantar wart: A case report and review

“…2 There are several case reports in the literature mistaking AMM for eczema, inflammatory plaques, pyogenic granuloma, verruca vulgaris, bowen's disease and basal cell or squamous cell carcinoma. [2][3][4] Other differential diagnoses include seborrheic keratosis, clavus, intraepidermal merkel cell carcinoma, foreign body granuloma and deep mycoses. Due to variety of clinical presentations, AMM often presents as an advanced lesion that has been wrongly treated by topical agents or local destructive procedures.…”

Teledermatology expedites urgent care for a case of acral melanoma with cutaneous in-transit metastases

“…8 Thus, there still is a need to advocate for skin cancer education to advance practice providers and PCPs, especially of atypical presentations. 9 We describe a patient presenting with an ulcerated nonhealing heel lesion for over a year, who was later correctly diagnosed with amelanotic melanoma initiated by a teledermatology encounter. As demonstrated in our case, teledermatology and its ease of access played a crucial role in expediting dermatologic care for this patient.…”

Acral Lentiginous Melanoma of the Thumb: Dermoscopy and Treatment

“…Early detection is crucial for the management of this tumor due to its high capacity for metastatic spread. Deng et al [2] documented a 42-year-old woman whose lesion was initially mistaken for a verruca plantaris before being confirmed as a stage IIIC metastatic acral melanoma.…”