Amelanotic Acral Lentiginous Melanoma of the Heel: A Case Report of Misdiagnosis

Acral lentiginous melanoma is an uncommon skin cancer that usually affects palms, soles, and nail apparatus of elderly Black and Asian individuals. Diagnosis is difficult, as it may mimic benign or traumatic lesions such as plantar warts or diabetic ulcers, especially if it is amelanotic. For this reason, detection is challenging, and proper diagnosis and treatment is often delayed, ultimately resulting in a poor prognosis. We report an 83-year-old Hispanic female with a two-year history of a painful, non-healing, glistening, exophytic mass on her left heel that was previously treated as a wart prior to proper biopsy and management. Patient education, complete physical exam and greater knowledge about this tumor, whether pigmented or not, are an important weapon to prevent its aggressiveness, increasing patients’ survival rate by decreasing the risk local invasion and metastasis. Biopsy should always be considered, especially in the setting of unresponsiveness to the treatment.