Palmar and plantar melanomas differ for sex prevalence and tumor thickness but not for dermoscopic patterns

Abstract

The specific anatomy of the glabrous skin, characterized by marked orthokeratosis and the presence of furrows and ridges, results in peculiar dermoscopic patterns of acral melanocytic lesions. Most frequently, acral nevi are typified by a parallel furrow pattern and acral melanoma (AM) by a parallel ridge pattern (PRP). Although the dermoscopic patterns of AM have been extensively investigated, little attention has been paid to site-related differences between palmar and plantar AM. The current study aimed to compare patients' characteristics, melanoma thickness, and the morphologic variability of AM depending on the localization on palms or soles. Patients demographics and dermoscopic images of 118 AM, including 99 (83.9%) plantar and 19 (16.1%) palmar lesions (mean thickness, 2.1 mm), were extracted from the databases of seven pigmented skin lesion clinics and were evaluated for the presence of predefined criteria. Palmar melanomas were remarkably more frequent in women (male-to-female ratio, 1/3.8) and thinner than plantar melanomas (1.3 vs. 2.2 mm). Dermoscopically, no significant differences were found between plantar and palmar melanomas, with PRP scored in 64.6 and 68.4% of plantar and palmar lesions, respectively. Non-site-specific melanoma criteria were detected in 83.9% of lesions and, among melanomas not exhibiting a PRP, 95.1% showed at least one non-site-specific melanoma criterion. In conclusion, plantar and palmar AMs show sex-related and thickness-related differences, but do not differ with respect to their dermoscopic features. For cases lacking the PRP, non-site-specific melanoma criteria may be considered as helpful additional clues for the correct diagnosis.

Nail apparatus melanoma thickness is associated with side and age

“…Lastly, in situ lesions were significantly more prevalent in fingernails than toenails, which is likely due to easier detection. A similar report has been published in the volar skin region . These clinical observations may shed light on the elusive pathogenesis of NAM, but should be confirmed by further studies.…”

“…A similar report has been published in the volar skin region. 10 These clinical observations may shed light on the elusive pathogenesis of NAM, but should be confirmed by further studies.…”

The BRAAFF checklist: a new dermoscopic algorithm for diagnosing acral melanoma

“…9,14-28 However, it has recently been shown that approximately one-third of AMs do not display a PRP, thus rendering their accurate diagnosis more difficult. 29 Some additional features, such as irregular diffuse pigmentation and other nonsite-specific melanoma criteria, have also been reported to characterize AM. [15][16][17][18]25,27 The aim of the present study was to develop and validate a multivariable dermoscopic prediction model for the differentiation between early AMs and acral naevi.…”

“…In acral pigmented lesions, dermoscopy enhances melanoma recognition by highlighting the accentuation of the pigmentation on the skin ridges [parallel ridge pattern (PRP), in contrast to the parallel furrow pattern (PFP) of acral naevi] . However, it has recently been shown that approximately one‐third of AMs do not display a PRP, thus rendering their accurate diagnosis more difficult . Some additional features, such as irregular diffuse pigmentation and other nonsite‐specific melanoma criteria, have also been reported to characterize AM …”

Scalp threading with polydioxanone monofilament threads: a novel, effective and safe modality for hair restoration

“…The role of sun exposure is not relevant for either the palm or sole; however, the palm is less weight bearing and is often exposed to more recurrent trauma. 7 Even though Lallas et al 8 found that palmar and plantar melanomas show similar dermoscopic features, there could be biological factors, such as trauma, mechanical stress or the lymphatic system, that might determine more aggressive clinical courses of melanomas arising on the palm. Follow-up of six patients with invasive palmar melanoma indicated regional or distant metastasis within 1 year.…”