Acral lentiginous melanoma. A clinicopathologic entity

Area of Science:

• Dermatology
• Oncology

Background:

• Acral lentiginous melanoma (ALM) is the fourth clinicopathologic variant of malignant melanoma.
• ALM commonly occurs on the volar surfaces of hands and feet, subungual areas, and digits.

Purpose of the Study:

• To describe the clinicopathologic features of acral melanoma (AM), including acral lentiginous melanoma (ALM).
• To analyze survival rates for patients with Stage I acral melanoma based on lesion location and treatment modality.

Main Methods:

• Retrospective analysis of 180 patients with acral melanoma (AM), with detailed documentation of ALM features in 67 patients.
• Evaluation of five-year survival rates for Stage I acral melanoma patients across different sites (plantar/palmar, subungual, digits) and treatment approaches.

Main Results:

• Acral lentiginous melanoma (ALM) is characterized by slow radial growth, thickening, heavy pigmentation, and dermal infiltration, often presenting as large, thick, ulcerated lesions.
• Five-year survival for Stage I acral melanoma varied by site: 63% for plantar/palmar, 58% for subungual, and 27% for digits.
• Stage I ALM patients treated with surgery and regional chemotherapy perfusion showed a 72% five-year survival rate.

Conclusions:

• Survival rates for acral lentiginous melanoma (ALM) are comparable to those for all acral melanoma (AM) lesions.
• Treatment outcomes for acral melanoma (AM) are site-dependent, with plantar/palmar lesions having better prognoses than those on digits.