Diagnostic challenges and importance of early multidisciplinary intervention in acral melanoma: a case report

Acral melanoma (AM) is a rare subtype of melanoma that occurs on acral sites such as the palms, soles, and subungual regions. Due to its atypical presentation and frequent lack of pigmentation in the amelanotic variant (AAM), diagnosis is often delayed, leading to a poor prognosis. We present the ca...

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Main Authors: Fortunato Cassalia, Paolo Del Fiore, Andrea Danese, Michele Soldà, Vincenzo Furfaro, Simone Mocellin
Format: Article
Language:English
Published: PAGEPress Publications 2025-05-01
Series:Dermatology Reports
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Online Access:https://www.pagepress.org/journals/dr/article/view/10332
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author Fortunato Cassalia
Paolo Del Fiore
Andrea Danese
Michele Soldà
Vincenzo Furfaro
Simone Mocellin
author_facet Fortunato Cassalia
Paolo Del Fiore
Andrea Danese
Michele Soldà
Vincenzo Furfaro
Simone Mocellin
author_sort Fortunato Cassalia
collection DOAJ
description Acral melanoma (AM) is a rare subtype of melanoma that occurs on acral sites such as the palms, soles, and subungual regions. Due to its atypical presentation and frequent lack of pigmentation in the amelanotic variant (AAM), diagnosis is often delayed, leading to a poor prognosis. We present the case of a 69-year-old woman with a chronic nail lesion that was initially misdiagnosed as onychomycosis and treated with partial onychectomy without histological evaluation. The lesion persisted, and subsequent dermatological evaluation revealed an ulcerated exophytic mass, which was confirmed as an acral nodular melanoma with a Breslow thickness of 7.5 mm. Despite surgical amputation, the patient’s management was complicated by wound infection and limited therapeutic options due to comorbidities. This case highlights the diagnostic challenges of AM and emphasizes the importance of early histopathological assessment and multidisciplinary collaboration for timely intervention and improved outcomes.
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series Dermatology Reports
spelling doaj-art-666ee8f6b5b646a7914172b2e145739d2025-08-20T02:26:19ZengPAGEPress PublicationsDermatology Reports2036-73922036-74062025-05-0110.4081/dr.2025.10332Diagnostic challenges and importance of early multidisciplinary intervention in acral melanoma: a case reportFortunato Cassalia0Paolo Del Fiore1Andrea Danese2Michele Soldà3Vincenzo Furfaro4Simone Mocellin5Dermatology Unit, Department of Medicine, University of Padua; Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, PaduaSoft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, PaduaSection of Dermatology and Venereology, Department of Medicine, University of VeronaU.O.S.D Orthopaedics and Traumatology, San Lorenzo Hospital, Valdagno, VicenzaU.O.S.D Orthopaedics and Traumatology, San Lorenzo Hospital, Valdagno, VicenzaSoft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, PaduaAcral melanoma (AM) is a rare subtype of melanoma that occurs on acral sites such as the palms, soles, and subungual regions. Due to its atypical presentation and frequent lack of pigmentation in the amelanotic variant (AAM), diagnosis is often delayed, leading to a poor prognosis. We present the case of a 69-year-old woman with a chronic nail lesion that was initially misdiagnosed as onychomycosis and treated with partial onychectomy without histological evaluation. The lesion persisted, and subsequent dermatological evaluation revealed an ulcerated exophytic mass, which was confirmed as an acral nodular melanoma with a Breslow thickness of 7.5 mm. Despite surgical amputation, the patient’s management was complicated by wound infection and limited therapeutic options due to comorbidities. This case highlights the diagnostic challenges of AM and emphasizes the importance of early histopathological assessment and multidisciplinary collaboration for timely intervention and improved outcomes. https://www.pagepress.org/journals/dr/article/view/10332Acral melanomaamelanotic melanomadelayed diagnosishistopathologymultidisciplinary management
spellingShingle Fortunato Cassalia
Paolo Del Fiore
Andrea Danese
Michele Soldà
Vincenzo Furfaro
Simone Mocellin
Diagnostic challenges and importance of early multidisciplinary intervention in acral melanoma: a case report
Dermatology Reports
Acral melanoma
amelanotic melanoma
delayed diagnosis
histopathology
multidisciplinary management
title Diagnostic challenges and importance of early multidisciplinary intervention in acral melanoma: a case report
title_full Diagnostic challenges and importance of early multidisciplinary intervention in acral melanoma: a case report
title_fullStr Diagnostic challenges and importance of early multidisciplinary intervention in acral melanoma: a case report
title_full_unstemmed Diagnostic challenges and importance of early multidisciplinary intervention in acral melanoma: a case report
title_short Diagnostic challenges and importance of early multidisciplinary intervention in acral melanoma: a case report
title_sort diagnostic challenges and importance of early multidisciplinary intervention in acral melanoma a case report
topic Acral melanoma
amelanotic melanoma
delayed diagnosis
histopathology
multidisciplinary management
url https://www.pagepress.org/journals/dr/article/view/10332
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