What is acral lentiginous melanoma?

Updated: Mar 08, 2019
  • Author: Jonathan B Heistein, MD; Chief Editor: Gregory Gary Caputy, MD, PhD, FICS  more...
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This tumor comprises 2-8% of melanomas in whites and 35-60% of melanomas in dark-skinned people. Cellular proliferation is present along the dermal-epidermal junction with microinvasion into the papillary dermis. The cells have increased melanin granule production, which fills their dendritic extensions. Acral lentiginous melanomas occur on the palms of the hands, beneath the nail beds, and on the soles of the feet. They may appear on the palms and soles as flat, tan, or brown stains with irregular borders. Subungual lesions can be brown or black, with ulcerations in later stages. Although previously no correlation with a worse prognosis was demonstrated for these lesions when tumor thickness was considered, a study by Asgari et al of 123 acral lentiginous melanomas indicated that in patients with these neoplasms, worse melanoma-specific survival can be linked to greater tumor thickness (Breslow depth of over 2 mm), as well as to more advanced tumor stage at presentation. [14]

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