Controversies in Acral Lentiginous Melanoma

Abstract

Progress in understanding ALM requires the development of standardized diagnostic criteria.

Melanoma in Maori, Asian, and Pacific Peoples in New Zealand

“…In those with a known subtype (i.e., excluding MM-NOS), SSM was the most common subtype in New Zealand Europeans, Maori, and Asians, whereas ALM was the most common subtype in Pacific peoples. It has been believed that ALM, first identified two and a half decades ago, occurred more often in black-skinned ethnic groups and behaved more aggressively than other melanoma subtypes (18). It is possible that the incidence of ALM, which develops on non-sun-exposed body sites, or the incidence of plantar melanoma is similar in all races but the proportion is higher in black-skinned and Pacific peoples as they have many fewer melanomas in total (19).…”

“…Furthermore, although consensus has not been reached, the reputed poorer prognosis of ALM is likely due to the tumor thickness and advanced stage at diagnosis (20). No significant progress has been made in elucidating the etiology of ALM, but because of its unusual site distribution, it is very likely to be different from other melanoma subtypes (18).…”

Misdiagnosed, Mistreated And Delay Diagnosed Acral Melanoma: The Atypical Presentations

“…In these case reports, the delay of a patient to go to be visited by a physician and the inappropriate diagnosis at first time is important reasons for the significant depth of the melanoma. Other factors that can contribute to this poor prognosis are the particular aggressiveness of AM [11] and the particular anatomic site, not routinely examined by patients or primary care physicians.…”

Current Management of Malignant Melanoma: State of the Art

“…The presence of small nevus cells may indicate a worse prognosis. Additionally lack of elastosis in dermis is prominent [105,113,123].…”