Use of magnetic resonance imaging as a noninvasive technique to identify acral lentiginous melanoma

doi:10.1016/j.jaad.2019.09.025

Journal of the American Academy of Dermatology

Volume 83, Issue 2, August 2020, Pages e121-e123

https://doi.org/10.1016/j.jaad.2019.09.025 Get rights and content

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Clinical challenge

Acral lentiginous melanoma may be a diagnostic challenge because the classic criteria for diagnosing pigmented lesions (asymmetry, border irregularities, color variegation, change in diameter) are often not apparent. Melanomas of the foot and ankle are frequently misdiagnosed as ulcerations, tinea pedis, and verrucae,¹ leading to a delay in diagnosis and progression of disease.

Solution

To help differentiate acral lentiginous melanoma from other pigmented lesions, this technology pearl presents the use of magnetic resonance imaging as a noninvasive technique to identify melanoma. A 76-year-old woman presented with a 10-year history of a small soybean-like lesion on the right heel. The lesion gradually increased and had an ulcerated area with black margins for 1 year. Magnetic resonance images showed an abnormal signal nodule on the heel (Fig 1, A), with internal hyperintense