Wouters Loes T C M, Thissen Monique R T M
Maastricht Universitair Medisch Centrum, afd. Dermatologie, Maastricht, the Netherlands.
Ned Tijdschr Geneeskd. 2012;156(34):A4927.
In Caucasians, the acrolentiginous melanoma is a rare type of melanoma and may appear on hands, feet and subungually. It has the worst prognosis of all melanomas, due to the high rate of misdiagnosis. In 30% of the patients, it presents amelanotic and may resemble for example a common wart, paronychia, ulceration or mycosis. We present 4 patients, aged 48 years and older, in whom an acrolentiginous melanoma was contemplated. One of the lesions was highly suspected of a subungual acrolentiginous melanoma, because of the presence of Hutchinson's sign. Another lesion presented amelanotic and mimicked a foot ulcer. Acrolentiginous melanoma should be considered in case of uncertain diagnosis, delay in healing, enlargement of the lesion and when a pigmented lesion is larger than 7 mm. In these situations, early histopathological examination should be performed.
在白种人中，肢端雀斑样痣性黑色素瘤是一种罕见的黑色素瘤类型，可能出现在手部、足部及甲下。由于误诊率高，它是所有黑色素瘤中预后最差的。30%的患者表现为无色素性，可能类似于例如寻常疣、甲沟炎、溃疡或真菌病。我们报告4例年龄在48岁及以上的患者，均考虑为肢端雀斑样痣性黑色素瘤。其中1例病变因出现哈钦森征而高度怀疑为甲下肢端雀斑样痣性黑色素瘤。另一例病变表现为无色素性，类似足部溃疡。在诊断不确定、愈合延迟、病变增大以及色素性病变大于7mm时，应考虑肢端雀斑样痣性黑色素瘤。在这些情况下，应尽早进行组织病理学检查。
