Acral Melanocytic Neoplasms: A Comprehensive Review of Acral Nevus and Acral Melanoma in Asian Perspective

Park, Sanghyun; Yun, Sook-Jung

doi:10.3390/dermatopathology9030035

Cited by 14 publications

(14 citation statements)

References 68 publications

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“…Most often, they are well-circumscribed and symmetric, although they can exhibit atypical features. 12…”

Section: Diagnosismentioning

confidence: 99%

Diagnosis and Management of Acral Pigmented Lesions

Ingrassia,

Stein,

Levine

et al. 2023

Dermatol Surg

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BACKGROUND Survival outcomes in acral lentiginous melanoma (ALM) are worse than for cutaneous melanoma. Diagnostic delays are believed to contribute to worse outcomes in ALM, including advanced-stage disease at initial presentation. Acral lentiginous melanoma, especially in its early stages, may be difficult to discern from benign pigmented acral lesions. OBJECTIVE The purpose of this article is to provide a comprehensive review of the diagnosis and management of acral pigmented lesions. MATERIALS AND METHODS A literature review was performed. The outcomes included were the clinical and dermoscopic features and the management frameworks and considerations for acquired and congenital melanocytic nevi, acral melanosis, nonmelanocytic pigmented lesions, and ALM. RESULTS Original research studies were primarily included. The use of dermoscopy, such as the 3-step algorithm and blotch (irregular), ridge pattern (parallel), asymmetry of structures, asymmetry of colors, furrow pattern (parallel), fibrillar pattern (BRAAFF) checklist, increases the diagnostic accuracy of acral pigmented lesions with high specificity and sensitivity. Short-term digital dermoscopic surveillance can be used to manage acral lesions, and histopathology should be collected when there is a concern for ALM. CONCLUSION The use of dermoscopy and an understanding of how to manage acral lesions may limit the number of biopsies performed on the acral skin, decrease the time to diagnosis, and facilitate early detection of ALM.

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“…Most often, they are well-circumscribed and symmetric, although they can exhibit atypical features. 12…”

Section: Diagnosismentioning

confidence: 99%

Diagnosis and Management of Acral Pigmented Lesions

Ingrassia,

Stein,

Levine

et al. 2023

Dermatol Surg

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“…Notably, non-acral and acral melanoma exhibit distinct characteristics, in terms of their prevalent subtypes, pathogenesis, metastatic patterns, and prognosis [25]. In acral melanoma patients, the statistically significant associations between melanoma pigmentation and cytokines may be attributed to specific underlying etiologies that is not seen in non-acral melanoma.…”

Section: Discussionmentioning

confidence: 99%

Correlations between inflammatory cytokine levels and degree of pigmentation in acral melanomas

Kim,

Park

et al. 2023

Melanoma Research

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Cutaneous melanoma, a highly aggressive skin tumor, is characterized by complex signaling pathways in terms of its pathogenesis and progression. Although the degree of pigmentation in melanoma determines its progression, metastasis, and prognosis, its association with inflammatory cytokines remains unclear. Thus, we evaluated the associations between melanoma pigmentation and plasma levels of inflammatory cytokines; furthermore, we investigated the potential variations in this relationship across the primary anatomic sites of melanoma. We enrolled patients with cutaneous melanoma who visited Chonnam National University Hwasun Hospital between January 2021 and December 2021. The anatomical sites of melanoma were categorized as acral and non-acral sites. The degree of pigmentation was quantified using computer software. In total, nine inflammatory cytokines were analyzed, including interleukin (IL)-2, IL-4, IL-5, IL-10, IL-12, IL-13, granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon-γ (IFN-γ), and tumor necrosis factor-α (TNF-α). This study included 80 melanoma patients. Of these, 53 had acral melanoma and 27 had non-acral melanoma. Overall, plasma concentrations of IL-2, IL-4, IL-5, GM-CSF, and IFN-γ demonstrated significant correlations with diminished pigmentation. Furthermore, in the acral melanoma patients group, plasma concentrations of IL-2, IL-4, IL-5, GM-CSF, IFN-γ, and TNF-α revealed significant correlations with diminished pigmentation. Our results reveal significant associations between melanoma pigmentation and various cytokine levels, particularly in acral melanoma patients; these associations can be influenced by factors related to acral melanoma, such as physical stress or trauma. These correlations may also provide directions for the treatment of acral melanoma.

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Section: Introductionmentioning

confidence: 99%

“…Acral-pigmented lesions are still less investigated by dermoscopy than facial or body-pigmented lesions, and the referring terminology is otherwise rather confused [ 1 , 2 , 3 , 4 , 5 ]. To date, the term “acral” has been used to define melanocytic lesions localized not only on volar glabrous skin surfaces of the extremities but also on the nail apparatus and subungual region—especially in reference to acral lentiginous melanoma (MM) [ 1 , 2 , 3 , 4 , 5 ]. Moreover, in many different studies to date, the terms “acquired acral nevi”, “congenital acral nevi”, “acral melanocytic lesions”, and “acral lentiginous melanoma” have been vaguely employed, without specifying if the lesions were on palms/soles or subungual region/nail.…”

Section: Introductionmentioning

confidence: 99%

A European Multicentric Investigation of Atypical Melanocytic Skin Lesions of Palms and Soles: The iDScore-PalmoPlantar Database

Tognetti,

Cartocci,

Lallas

et al. 2024

Diagnostics

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Background: The differential diagnosis of atypical melanocytic palmoplantar skin lesions (aMPLs) represents a diagnostic challenge, including atypical nevi (AN) and early melanomas (MMs) that display overlapping clinical and dermoscopic features. We aimed to set up a multicentric dataset of aMPL dermoscopic cases paired with multiple anamnestic risk factors and demographic and morphologic data. Methods: Each aMPL case was paired with a dermoscopic and clinical picture and a series of lesion-related data (maximum diameter value; location on the palm/sole in 17 areas; histologic diagnosis; and patient-related data (age, sex, family history of melanoma/sunburns, phototype, pheomelanin, eye/hair color, multiple/dysplastic body nevi, and traumatism on palms/soles). Results: A total of 542 aMPL cases—113 MM and 429 AN—were collected from 195 males and 347 females. No sex prevalence was found for melanomas, while women were found to have relatively more nevi. Melanomas were prevalent on the heel, plantar arch, and fingers in patients aged 65.3 on average, with an average diameter of 17 mm. Atypical nevi were prevalent on the plantar arch and palmar area of patients aged 41.33 on average, with an average diameter of 7 mm. Conclusions: Keeping in mind the risk profile of an aMPL patient can help obtain a timely differentiation between malignant/benign cases, thus avoiding delayed and inappropriate excision, respectively, with the latter often causing discomfort/dysfunctional scarring, especially at acral sites.

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Acral Melanocytic Neoplasms: A Comprehensive Review of Acral Nevus and Acral Melanoma in Asian Perspective

Cited by 14 publications

References 68 publications

Diagnosis and Management of Acral Pigmented Lesions

Diagnosis and Management of Acral Pigmented Lesions

Correlations between inflammatory cytokine levels and degree of pigmentation in acral melanomas

A European Multicentric Investigation of Atypical Melanocytic Skin Lesions of Palms and Soles: The iDScore-PalmoPlantar Database

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