Various biologic agents for psoriasis were effective at 12 weeks in placebo-controlled trials. Available data cannot fully account for situations in clinical practice, in which combination and longer duration of therapy may be required. When choosing the most effective or best agent, multiple factors should be considered including patient preference, cost, tolerance, adverse effects, dosing schedule, and mode of administration.

e20029 Background: Acral melanoma (AM) is a distinct subtype of melanoma that displays a higher proclivity in the minority population. AM is associated with a worse outcome in comparison to conventional cutaneous melanoma (CM). Asian/Pacific Islanders with AM in particular, exhibit the poorest survival amongst all ethnic groups. Recent studies have profiled the importance of +8q and 8q24 as markers for an adverse prognosis in CM. However, a focused chromosomal analysis of minority patients with AM at this locus has not been previously described. Methods: IRB approval was obtained for this retrospective analysis. From 2004 to 2012, 14 Asian/Pacific Islander patients histologically confirmed to have invasive AM were evaluated at a tertiary institution. Data including age, gender, tumor location, Breslow thickness, ulceration, and mitoses per mm squared were compiled. In situ hybridization was performed targeting the centromeric region of chromosome 8 (Vysis CEP 8-FITC) and the myelocytomatosis viral oncogene homolog locus (MYC; 8q24.12 q24.13, Vysis LSI-Spectrum Orange). The overall ratio of signals and individual spot counts for CEP8 and 8q24 was recorded. Results: Our findings demonstrated that +8q chromosomal aberrations were highly prevalent (8/14; 57%). The majority of our entire cohort (7/14; 50%) exhibited thick primary lesions (>4.0 mm) with a high propensity for ulceration. There were no copy number gains in 8q24. Demographics of the Asian/Pacific Islander cohort included mean age of 67.4 years old (range 43-86) and male gender 9/14 (64%). Tumor location principally involved the foot 11/14 (79%); mean Breslow thickness was 4.6 mm (range 0.9-11.0), ulceration 7/14 (50%), and mean mitoses per mm squared was 3.4 (range 0-9). Conclusions: Asian/Pacific Islanders with AM were found to have a high frequency of +8q chromosomal alterations. There appeared to be an association with a thicker Breslow and presence of ulceration. This is the first study to our knowledge that has examined chromosomal aberrations of +8q and 8q24 in a non-Caucasian population of AM patients. This is compelling data that may be applied to future prognostic classifications.