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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Acral lentiginous melanoma &#40;ALM&#41; is a relatively rare subtype of melanoma in whites&#44; in whom it accounts for just 1&#37; to 2&#37; of all melanomas&#46; There is no evident link to solar radiation&#46; ALM affects the palms and soles and the area around the nail unit and generally carries a poor prognosis associated with several factors&#44; including late diagnosis and&#44; in all likelihood&#44; tumor biology&#46; Accordingly&#44; it is frequently diagnosed in unfavorable circumstances&#44; such as high Breslow thickness&#44; tumor ulceration&#44; and locoregional metastasis&#46; Reasons for diagnostic delay attributable to patients<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> include old age&#44; unfamiliarity with the clinical presentation of ALM among the general population&#44; and difficulty examining hard-to-access areas in old age&#46; Diagnostic delays attributable to primary care doctors<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> can be explained by a failure to detect lesions early due to insufficient training&#44; particularly in the case of in situ melanomas that present with longitudinal melanonychia&#46; ALMs with atypical clinical presentations may also be diagnosed late due to confusion with a variety of benign and malignant conditions&#44; such as pyogenic granulomas&#44; infections&#44; nonspecific ulcers&#44; and squamous cell carcinoma&#46; This possibility is greater in the case of amelanotic or hypomelanotic ALMs&#46; Dermoscopy training for primary care physicians and specialists and encouragement of self-examination of hands and feet within melanoma prevention campaigns could contribute to early diagnosis and better prognosis in ALM&#46;</p></span>"
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