Depending on the source, 2% to 8% of melanomas are amelanotic and are misdiagnosed as pyogenic granulo-mas, angiokeratomas, basal cell carcinomas, squamous cell carcinomas, warts, seborrheic keratoses, scars, or even inflammatorylesions. A sentinel paper, '"Melanoma? It Can't Be Melanoma!' A Subset of Melanomas That Defies Clinical Recognition," reviewed more than 50,000 specimens submitted to a large metropolitan university dermatopathology laboratory over a 1-year period in which 178 melanomas were diagnosed. Of these, 13 (7.4%) were completely unsuspected, leading the authors, as well as others, to conclude that some melanomas defy recognition clinically.
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