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Tumor thicknesses ranged from 4.7 to 10.5 mm. Mitoses were rare. All tumors showed perineural invasion. None was associated with solar elastosis, vascular invasion, or satellites. Comment. Desmoplastic melanoma is an important subtype of melanoma because it represents a diagnostic pitfall and has a distinct clinical behavior. 1 It has a higher rate of local recurrence and lower incidence of sentinel lymph node involvement than conventional melanoma, especially if the DM is histopathologically pure in appearance. 2,3 It is of interest that the DMs of the 3 African American women described herein lacked an associated intraepidermal (in situ) melanoma component as well as evidence of solar elastosis, which suggests a cause independent of chronic sun damage. Most melanomas in African Americans are acral tumors or melanomas of superficial spreading type. Based on Surveillance, Epidemiology, and End Results (SEER) data (1992-2002), 7 of 251 primary invasive melanomas of African Americans were reported as desmoplastic. 4 However, they were not further characterized with regard to histopathologic subtype (pure vs mixed) or anatomic site. One case report of a tumor said to be desmoplastic was an acral melanoma. 5 After review of its histopathologic illustrations, we interpret it as a mixed DM. 5 Herein, we report for the first time to our knowledge the occurrence of pure DMs at nonacral sites in African American women.

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Ultraviolet (UV) radiation is a notorious environmental carcinogen. Acute and chronic UV radiation exposure increase the risk for skin cancer. Protecting oneself from both UVA and UVB radiation with broad-based sunscreen can prevent certain skin cancers, their precursors, and photoaging. Although sun protection factor only measures UVB protection, it is essential to consider protection from UVA radiation when deciding on a particular sunscreen product. Awareness of particular controversies associated with sunscreen, such as vitamin D deficiency and sunscreen toxicity, is necessary to adequately counsel patients with sunscreen concerns. Additionally, all physicians should be familiar with sunscreen composition, proper use, and benefits while encouraging patient compliance.