Abstract
BackgroundMalignant 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.MethodsA 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.ResultsA 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.ConclusionsThe 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.
Highlights
The incidence of malignant melanoma (MM) continues to rise in the UK and Europe [1]
Despite being an uncommon form of skin cancer it is responsible for the majority of skin cancer deaths [2]
Health education campaigns have increased public awareness of the problem and there is evidence to show that sectors of the population are presenting earlier with their suspicious skin lesions [3,4,5]
Summary
The incidence of malignant melanoma (MM) continues to rise in the UK and Europe [1]. Despite being an uncommon form of skin cancer it is responsible for the majority of skin cancer deaths [2]. Health education campaigns have increased public awareness of the problem and there is evidence to show that sectors of the population are presenting earlier with their suspicious skin lesions [3,4,5]. Despite these improvements, mortality and morbidity still remains high, within subsets of the population such as older adults [6,7], males [8,9,10], the less affluent [11] and less well educated [12,13]. Evidence suggests that due to misdiagnosis and later recognition, foot melanoma has a poorer prognosis than cutaneous melanoma elsewhere
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