Acral lentiginous melanoma A clinicopathologic study of 36 patients

Abstract

Acral lentiginous melanoma (ALM) is a distinct variant of malignant melanoma with a predilection for the soles, palms, and nail beds. This melanoma has characteristic histologic features, and its biologic behavior is similar to that of nodular melanoma. It occurs predominantly in the sixth, seventh, and eighth decades of life, with a peak incidence in the seventh decade for males and in the sixth decade for females. Diagnosis of ALM during the radial growth phase is often difficult, and it may not be recognized initially, but treatment in this phase offers an excellent prognosis. There is a high incidence of regressive changes and desmoplasia in ALM; these changes, together with the anatomic peculiarities of nail beds, palms, and soles as compared with other skin areas, make it difficult to determine the Clark's level and to measure the depth of invasion. Wide local excision with lymph node dissection is recommended for subungual melanomas measuring more than 1.00 mm and for lesions showing severe regression. Volar melanomas less than 1.00 mm deep and those in the radial growth phase with minimal invasion require only wide local excision. Amputation of digits and lymph node dissection are recommended for subungual melanomas, if the melanomas exhibit the vertical growth phase. If there is only radial growth without regressive changes, wide local excision is adequate. Patients with metastasis to lymph nodes at the time of diagnosis usually have shorter survival times than do those without lymph node involvement (P = 0.027). Cancer 52:161‐168, 1983.

Acral Lentiginous Melanoma

“…Several single institution case series of ALM have been published 6,7,8,9,10,11. However, since this subtype of melanoma is rare, these studies have been limited by small sample sizes and have not been population-based.…”

Acral Melanoma in Chinese: A Clinicopathological and Prognostic Study of 142 cases

“…The Surveillance, Epidemiology, and End Results (SEER) data exhibited that the clinical features, anatomical origin, and patients’ prognoses differ significantly among different ethnic groups2. AM is rare in Caucasians (1–7%) but has higher incidence in non-White individuals345678, accounting for up to 58% of all cutaneous melanomas in Asians9 and even more (60–70%) in Blacks10. It is often misdiagnosed or ignored before an accurate diagnosis is made because it is hidden from view1112.…”

Nail apparatus melanoma: A comparative, clinicoprognostic study of the initial clinical and morphological characteristics of 49 patients

“…[1][2][3][4][5][6] However, about 50% of all cutaneous melanomas in an Asian cohort and 60% to 70% in a black population presented with acral melanoma. [7][8][9] The nail apparatus is a site of predilection, including the subungual and periungual areas, and accounts for 20% to 30% of all acral melanomas and 10% to 20% of all cutaneous melanomas in Asian patients.…”