Malignant melanoma of the heel.

Primary cutaneous melanomas are usually divided into three separate clinicopathologic groups: lentigo maligna melanoma (LMM), superficial spreading melanoma. (SSM), and nodular melanoma (NM). Acral lentiginous melanoma has been described as the fourth distinct subtype to denote those melanomas that arise on volar and subungual skin. This entity is said to have a radial growth phase histologically similar to that of lentigo maligna melanoma. Because of the acral distribution of the tumour and the radial lentiginous proliferation of tumour cells the lesions were named acral lentiginous melanomas (ALM) . Pathologic subclassification and evaluation of the level of invasion or tumour thickness of malignant cutaneous melanomas are important for prognosis and appropriate treatment. Melanoma of the foot is twice as common in women as in men, and has highest frequency in the older age group. The distribution of malignant melanoma on the foot shows the greatest density on the sole of the foot and on the heal. Tumours of the hand and feet, especially malignant tumours, are very rare and their incidence, compared to those of other cutaneous regions of the body is considerably lower. This is interesting since the skin surface of these two organs is 10% of the body surface. The greatest incidence is between 50 and 70 years of age with about the same number of patients in each of these decades.