Acral (volar-subungual) melanoma.

Area of Science:

• Dermatology
• Oncology
• Pathology

Background:

• Acral melanoma is a distinct malignant melanoma subtype.
• It occurs on the volar surfaces of extremities and subungual areas.
• Characterized by unique clinical and pathological features.

Purpose of the Study:

• To analyze the clinical characteristics, treatment, and outcomes of acral melanoma.
• To highlight the challenges in diagnosing acral melanoma.
• To evaluate the efficacy of various treatment modalities.

Main Methods:

• Retrospective analysis of 340 malignant melanoma patients.
• Inclusion of 24 patients diagnosed with acral melanoma.
• Review of clinical presentation, histological findings, staging, treatment, and patient outcomes.

Main Results:

• Acral melanoma constituted 7% of malignant melanoma cases.
• Diagnosis delay ranged from 6 months to 5 years, with most presenting as advanced tumors.
• Acral lentiginous melanoma histology was observed in 14 cases.
• 14 patients were stage I, 7 stage II, and 3 stage III at diagnosis.
• Surgical excision was the primary treatment; amputation and lymph node dissection were performed.
• Regional metastases were found in 9 of 14 patients undergoing lymph node dissection.
• 14 patients died from metastatic disease within 1-5 years; 4 have metastatic spread; 6 are disease-free.

Conclusions:

• Acral melanoma presents unique diagnostic and therapeutic challenges.
• Delayed diagnosis significantly impacts prognosis.
• Multidisciplinary treatment approaches are essential for managing acral melanoma.
• Further research is needed to improve early detection and treatment strategies.