• accurate
• dermatology
• medical dermatology
• precise
• procedural dermatology
• surface anatomy
• surgical dermatology
• terminology

• Humans
• Dermatology/methods
• Dermatology/standards
• Delphi Technique
• Terminology as Topic
• Skin/pathology
• Skin/diagnostic imaging
• Skin/anatomy & histology
• Skin Diseases/diagnosis
• Skin Diseases/pathology
• Skin Diseases/therapy
• Skin Neoplasms/pathology
• Skin Neoplasms/diagnosis
• Anatomic Landmarks
• Clinical Relevance

• biopsy
• diabetic foot ulcer
• fungating mass
• malignant melanoma
• misdiagnosis
• neoplastic ulcers
• wound
• wound care
• wound dressing
• wound healing

• Humans
• Female
• Aged
• Skin Neoplasms/diagnosis
• Skin Neoplasms/pathology
• Heel
• Melanoma/diagnosis
• Melanoma/pathology
• Diabetic Foot/diagnosis
• Diabetic Foot/therapy
• Diagnosis, Differential
• Fatal Outcome
• Melanoma, Cutaneous Malignant
• Foot Ulcer/diagnosis
• Foot Ulcer/therapy
• Foot Ulcer/pathology

• Cutaneous melanoma
• Foot
• Lower limb
• Prognostic

• Humans
• Melanoma/mortality
• Melanoma/therapy
• Skin Neoplasms/mortality
• Skin Neoplasms/therapy
• Lower Extremity/surgery
• Disease-Free Survival
• Male
• Female
• Adult
• Middle Aged
• Aged
• Survival Rate
• Spain/epidemiology
• Prognosis

• Universidad de Murcia

• Humans
• Asian/statistics & numerical data
• Head and Neck Neoplasms/ethnology
• Head and Neck Neoplasms/mortality
• Head and Neck Neoplasms/pathology
• Head and Neck Neoplasms/surgery
• Lymphatic Metastasis
• Melanoma/ethnology
• Melanoma/mortality
• Melanoma/pathology
• Melanoma/surgery
• Neoplasm Staging
• Prognosis
• Retrospective Studies
• Skin Neoplasms/ethnology
• Skin Neoplasms/mortality
• Skin Neoplasms/pathology
• Skin Neoplasms/surgery
• Skin Ulcer/ethnology
• Skin Ulcer/etiology

• Humans
• Skin Neoplasms/diagnosis
• Skin Neoplasms/pathology
• Melanoma/diagnosis
• Melanoma/pathology
• Melanoma/prevention & control
• Skin/pathology
• Early Diagnosis

Acral Lentiginous Melanoma (ALM) transpires in a profoundly scarce percentage of the population and is intercalated with a low survival rate. This is partly because such tumors are chiefly diagnosed at an advanced stage. Diagnosis is delayed largely due to the difficulties in recognizing the early histopathological signs and clinical presentations of Acral Melanoma.

We demonstrate the case of a previously healthy 69-year-old Middle Eastern male patient, who presented to our university hospital's Dermatology clinic with a papule under the right ring fingernail with spontaneous Onycholysis of the entire nail, suggesting a spontaneous malformation in his finger.

ALM is an abundantly rare subtype of melanoma that chiefly originates from the skin of the acral tissues. In this case it arose on the fingernail of a 69-year-old male, who has undergone 2 surgeries to eradicate the tumor with safe margins and as a ramification of successful follow-up for 6 months, has been deemed free of tumor recurrence or metastasis.

The aim of this article is to highlight the vitality of early detection, diagnosis, prognosis, and treatment of malignant Acral Lentiginous Melanoma in patients of all ages, especially with older patient populations.

•

Acral Lentiginous Melanoma constitutes approximately 2–3 % of all classes of melanomas.

• free tissue flaps
• melanoma
• protocol
• reconstructive surgical procedures

• Free Tissue Flaps/surgery
• Humans
• Melanoma/surgery
• Plastic Surgery Procedures/methods
• Retrospective Studies
• Skin Neoplasms/surgery

• diabetic foot ulcer
• malignancy
• melanoma
• misdiagnosis
• skin cancer

• Adult
• Aged
• Diabetes Mellitus
• Diabetic Foot/complications
• Diagnostic Errors
• Foot
• Foot Ulcer
• Humans
• Incidence
• Skin Neoplasms/complications
• Skin Neoplasms/diagnosis

• 075-15-2020-926 Ministry of Science and Higher Education of the Russian Federation
• Ministry of Science and Higher Education of the Russian Federation

• Cohort Studies
• Female
• Humans
• Lymphatic Metastasis
• Melanoma/pathology
• Middle Aged
• Prognosis
• Retrospective Studies
• Sentinel Lymph Node Biopsy
• Skin Neoplasms/pathology

• UL1 TR001863 NCATS NIH HHS

Static mechanical compression is a biomechanical factor that affects the progression of melanoma cells. However, little is known about how dynamic mechanical compression affects the progression of melanoma cells. In the present study, we show that mechanical intermittent compression affects the progression rate of malignant melanoma cells in a cycle period-dependent manner. Our results suggest that intermittent compression with a cycle of 2 h on/2 h off could suppress the progression rate of melanoma cells by suppressing the elongation of F-actin filaments and mRNA expression levels related to collagen degradation. In contrast, intermittent compression with a cycle of 4 h on/4 h off could promote the progression rate of melanoma cells by promoting cell proliferation and mRNA expression levels related to collagen degradation. Mechanical intermittent compression could therefore affect the progression rate of malignant melanoma cells in a cycle period-dependent manner. Our results contribute to a deeper understanding of the physiological responses of melanoma cells to dynamic mechanical compression.

• cancer progression
• in vitro model
• malignant melanoma
• mechanical intermittent compression

Our purpose was to collect data on the incidence of malignant skin tumours presenting as chronic leg or foot ulcers in a tertiary centre, and to analyse the frequency and type of initial clinical misdiagnoses in these cases. A retrospective chart review of cases with melanoma or other malignant neoplasms of the skin of the lower extremity treated in a tertiary centre during January 2010 until February 2020 was conducted to identify cases that presented as chronic ulcers. Out of 673 cases, 26 (3.9%) were identified with a total of 27 malignant tumours presenting as chronic ulcers of the lower leg or foot. Therefrom, seven were diagnosed as melanoma, eight as squamous cell carcinoma, and twelve as basal cell carcinoma. The mean interval until diagnosis for all tumour types was 44.4 months (median 24 months). A delay in correct treatment occurred in 12 out of 26 cases (46%) as a result of misdiagnosis with subsequent treatment as chronic leg or foot ulcers of a different etiology. Misdiagnoses were venous ulcer, traumatic wound, mixed arterial and venous ulcer, arterial ulcer, and ulcer of an unknown origin. Malignant ulcers presenting as chronic ulcers are rare, but often lead to misdiagnosis.

• basal cell carcinoma
• chronic ulcer
• melanoma
• squamous cell carcinoma
• venous leg ulcers

• Acral
• Delayed diagnosis
• History taking
• Melanoma
• Misleading

• Attitudes
• Knowledge
• Malignant melanoma
• Skills
• Sri Lanka

• foot ulcer
• malignant melanoma
• misdiagnosis

• Aged
• Diabetes Mellitus, Type 2/complications
• Diabetic Foot/diagnosis
• Diabetic Foot/drug therapy
• Diabetic Foot/pathology
• Diagnostic Errors
• Female
• Foot/pathology
• Foot/surgery
• Humans
• Melanoma/diagnosis
• Melanoma/pathology
• Melanoma/therapy
• Skin Neoplasms/diagnosis
• Skin Neoplasms/pathology
• Skin Neoplasms/therapy
• Melanoma, Cutaneous Malignant

• Basal cell carcinoma
• Dermoscopy
• Excision margin
• Histopathologic
• Melanoma
• Melanonychia
• Squamous cell carcinoma

The etiology and pathogenesis of lentiginous acral melanomas are poorly understood. Recent studies have postulated that DNA repair mechanisms and cell growth pathways are involved in the development of melanoma, particularly changes in the MAPK pathways (RAS, BRAF, MEK 1/2, and ERK 1/2). The aim of this study is to assess the status of the MAP kinase pathways in the pathogenesis of acral melanomas. The authors examined the components of the RAS–RAF–MEK–ERK cascades by immunohistochemistry in a series of 16 primary acral melanomas by tissue microarray. The expression of MAP kinase cascade proteins changed in most cases. The authors observed that 57.14% of cases were BRAF positive and that 61.53%, 71.42%, and 71.42% of cases were positive for MEK2, ERK1, and ERK2, respectively; RAS was not expressed in 92.31%, and all cases were negative for MEK1. The absence of RAS and positivity for MEK2, ERK1, and ERK2 were most seen in invasive cases with high thickness. These aspects of the MAPK pathway require further examination in acral melanomas between different populations. Nevertheless, the results highlight significant alterations in the MAP kinase cascades that are related to histological indicators of prognosis in primary acral melanomas.

• chronic wound
• disease-free survival
• foot
• malignant melanoma
• misdiagnosis
• prognosis
• overall survival rate

• Adult
• Aged
• Cohort Studies
• Delayed Diagnosis/adverse effects
• Diagnostic Errors/adverse effects
• Female
• Foot
• Humans
• Kaplan-Meier Estimate
• Male
• Melanoma/diagnosis
• Melanoma/mortality
• Melanoma/pathology
• Middle Aged
• Neoplasm Staging
• Prognosis
• Skin Neoplasms/diagnosis
• Skin Neoplasms/mortality
• Skin Neoplasms/pathology
• Young Adult

• Acral
• Cancer
• Foot
• Melanoma
• Nail
• Skin

An estimated 73870 people will be diagnosed with melanoma in the United States in 2015, resulting in 9940 deaths. The majority of patients with cutaneous melanomas are cured with wide local excision. However, current evidence supports the use of sentinel lymph node biopsy (SLNB) given the 15%-20% of patients who harbor regional node metastasis. More importantly, the presence or absence of nodal micrometastases has been found to be the most important prognostic factor in early-stage melanoma, particularly in intermediate thickness melanoma. This review examines the development of SLNB for melanoma as a means to determine a patient’s nodal status, the efficacy of SLNB in patients with melanoma, and the biology of melanoma metastatic to sentinel lymph nodes. Prospective randomized trials have guided the development of practice guidelines for use of SLNB for melanoma and have shown the prognostic value of SLNB. Given the rapidly advancing molecular and surgical technologies, the technical aspects of diagnosis, identification, and management of regional lymph nodes in melanoma continues to evolve and to improve. Additionally, there is ongoing research examining both the role of SLNB for specific clinical scenarios and the ways to identify patients who may benefit from completion lymphadenectomy for a positive SLN. Until further data provides sufficient evidence to alter national consensus-based guidelines, SLNB with completion lymphadenectomy remains the standard of care for clinically node-negative patients found to have a positive SLN.

• Melanoma
• Metastasis
• Review
• Biologic characteristics
• Sentinel lymph node
• Sentinel lymph node biopsy

• acral melanoma
• melanoma
• metastatic melanoma
• natural history of disease

• Acral lentiginous melanoma
• Dermoscopy
• Diabetic foot
• Foot ulcer

• Content analysis
• Dermatology
• History
• Podiatry

Background. Acral lentiginous melanoma (ALM) is a less-common form of melanoma in US, and it accounts for about 5% of all diagnosed melanomas in US. ALM is often overlooked until it is well advanced because of the lesion's location and its atypical appearance in the early stages. We present a case of ALM initially presented as a diabetic foot ulcer. Case Report. An 81-year-old man initially presented to the primary care clinic with a right foot diabetic ulcer. There was a large plantar, dark-colored ulcer that bled easy. Initial excision biopsy revealed Clark's Level IV ALM. Subsequent definitive wide excision and sentinel node biopsy confirmed ALM with metastasis to inguinal lymph nodes (stage IIIb). The treatment included wide margin excision of the lesion with en bloc amputations of 4th and 5th toes, followed by adjuvant chemotherapy. Discussion. The development of ALM may potentially relate to diabetes as a reported higher prevalence of diabetes with ALM patients. Conclusion. The difficulty in early diagnosing of ALM remains as a formidable challenge particularly in diabetic patients who commonly develop plantar foot ulcers due to the diabetic neuropathy. This case reiterates the importance of a thorough foot exam in such patients.

Malignant melanoma is a life threatening skin tumour which may arise on the foot. The prognosis for the condition is good when lesions are diagnosed and treated early. However, lesions arising on the soles and within the nail unit can be difficult to recognise leading to delays in diagnosis. These guidelines have been drafted to alert health care practitioners to the early signs of the disease so an early diagnosis can be sought.

Malignant melanoma is a rare but potentially lethal form of cancer which may arise on the foot. Evidence suggests that due to misdiagnosis and later recognition, foot melanoma has a poorer prognosis than cutaneous melanoma elsewhere.

A panel of experts representing podiatry and dermatologists with a special interest in skin oncology was assembled to review the literature and clinical evidence to develop a clinical guide for the early recognition of plantar and nail unit melanoma.

A systematic review of the literature revealed little high quality data to inform the guide. However a significant number of case reports and series were available for analysis. From these, the salient features were collated and summarised into the guide. Based on these features a new acronym "CUBED" for foot melanoma was drafted and incorporated in the guide.

The use of this guide may help clinicians in their assessment of suspicious lesions on the foot (including the nail unit). Earlier detection of suspicious pedal lesions may facilitate earlier referral for expert assessment and definitive diagnosis. The guide is currently being field tested amongst practitioners.

Melanoma is responsible for 1% to 2% of all cancer deaths around the world. Nodular melanoma often carries a poor prognosis because of no prodromal radial growth phase, early distant metastasis and significant tumor volume.

We present a case of progressive melanoma. A 51-year-old man was admitted to our hospital with dyspnea and skin lesions. These were multiple, dark colored, firm, and nodular and varied in size. He was diagnosed with melanoma. Temozolomide was administered, but he died of respiratory failure within a week after diagnosis.

Nodular melanoma tends to spread rapidly and eventually metastasize to vital organs. It may be fatal within months of recognition.

Journal of Foot and Ankle Research was launched one year ago, and a number of its key achievements are highlighted in this editorial. Although the journal is underpinned by professional bodies associated with the podiatry professions in the UK and Australasia, its content is aimed at the wider foot and ankle research community. Nevertheless, the journal's achievements over the past year reflect the development of research in the profession of podiatry. From this perspective, the journal may be viewed as contributing to the overall attainment of some of the profession's key goals and strategic aims over the last decade, across the UK and Australasia. The journal has also witnessed policy changes in the last year, and these are discussed - notably, the decision not to accept case reports for publication. We also report on a few of the key metrics, providing readers with a summary of the journal's performance over the last year.

• Acral
• Melanoma
• Nevi
• Palms
• Soles