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Updated: Feb 6, 2026
07:41
A Robust Discovery Platform for the Identification of Novel Mediators of Melanoma Metastasis
Published on: March 8, 2022
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Identification of Risk Factors for Acral Melanoma in US Veterans
Jonathan C Hwang1,2,3, Linden B Huhmann4, Kelly Cho4,5,6
1University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
JAMA Dermatology
|February 4, 2026
Summary
Agent Orange exposure (AOE) was linked to increased acral melanoma (AM) risk in US veterans. Smoking was associated with lower AM odds, while prior skin conditions like keratinocyte carcinoma (KC) and actinic keratosis (AK) showed mixed associations.
Area of Science:
- Dermatology and Oncology
- Veterans Health Research
- Environmental Epidemiology
Background:
- Acral melanoma (AM), a distinct subtype occurring on palms, soles, and nail units, is less associated with UV radiation exposure.
- Limited research exists on AM risk factors specifically within the US veteran population.
- Understanding these factors is crucial for targeted prevention and early detection strategies.
Purpose of the Study:
- To identify and analyze risk factors associated with acral melanoma (AM) in a cohort of US veterans.
- To compare risk factors for AM against non-acral cutaneous melanoma (CM) and individuals without melanoma.
Main Methods:
- A nested case-control study was conducted within the Veterans Affairs (VA) healthcare system from 2000 to 2024.
- Acral melanoma cases were identified using the VA Cancer Registry and natural language processing of pathology reports.
- Cases were matched with controls (no melanoma and non-acral CM) based on diagnosis year and outpatient visit frequency.
Main Results:
- Agent Orange exposure (AOE) was significantly associated with increased odds of AM compared to both non-melanoma controls and CM.
- Current smoking demonstrated a significant association with lower odds of developing AM.
- Prior keratinocyte carcinoma (KC) and actinic keratosis (AK) were linked to higher AM odds versus no melanoma, but lower odds compared to CM; prior nevi were associated with higher AM odds versus no melanoma.
Conclusions:
- The study identifies key factors, including AOE and smoking status, associated with AM in US veterans.
- Findings support the investigation of AM as a distinct entity from cutaneous melanoma (CM).
- Results may inform future research on AOE and AM associations, particularly in veteran populations.
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