II. Epidemiology

  1. Represents 2.5% of Melanomas
  2. Account for 50% of Melanomas in dark skinned patients

III. Pathophysiology

  1. Type of Acral Lentiginous Melanoma

IV. Characteristics

  1. Longitudinal brown-black streak
  2. May encompass entire nail
  3. Hutchinson's Nail Sign
    1. Melanoma affecting proximal nail fold skin

V. Evaluation: Factors suggesting Melanoma

  1. Recent change (e.g. band wider or darker)
  2. Hutchinson's Sign (see above)
  3. Individual nail involvement (especially first digit)
  4. Longitudinal band >3 mm wide (or widens at the proximal nail)
  5. Nail plate disruption
  6. New onset in caucasian or age >60 years
    1. May be normal variant in dark-skinned patients
    2. However, Melanoma also occurs in dark-skin patients

VI. Differential Diagnosis

VII. Management

  1. Acral Lentiginous Melanoma is a very aggressive tumor with early metastasis even from small lesions

VIII. Prognosis

  1. Five year survival is as low as 50%

IX. References

  1. Habif (2003) Clinical Dermatology, 4th ed.. Mosby, p. 773-813
  2. Rager (2005) Am Fam Physician 72:269-76 [PubMed]

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Ontology: Acral Lentiginous Malignant Melanoma (C0346037)

Definition (NCI) A form of melanoma occurring most often on the plantar, palmar, subungual, and periungual skin. It presents as a pigmented macular lesion with irregular borders. Morphologically, it consists of atypical spindled and dendritic melanocytes. The epidermis is often hyperplastic and there is pagetoid infiltration of the epidermis by anaplastic cells.
Concepts Neoplastic Process (T191)
ICD10 M8744/3
SnomedCT 189755003, 16974005, 254732008
English ALM-Acral lentig melanoma skin, ALMM-Acral lentiginous MM skin, Acral lentig melanoma,malig, Acral lentigin melanoma skin, Acral lentiginous MM of skin, Malig acral lentigin melanoma, Malignant acral lentiginous melanoma, [M] Acral lentiginous melanoma, malignant, [M]Acral lentig melanoma,malig, Acral Lentiginous Melanoma, acral lentiginous melanoma of skin, acral lentiginous melanoma of skin (diagnosis), malignant acral lentiginous melanoma, Acral Lentiginous Malignant Melanoma, acral lentiginous melanoma, Acral lentiginous melanoma, Malignant acral lentiginous melanoma (disorder), [M]Acral lentiginous melanoma, malignant, ALM - Acral lentiginous melanoma of skin, ALMM - Acral lentiginous malignant melanoma of skin, Acral lentiginous malignant melanoma of skin, Acral lentiginous melanoma of skin, Acral lentiginous melanoma, malignant, Acral lentiginous malignant melanoma of skin (disorder), Acral lentiginous melanoma, malignant (morphologic abnormality), acral lentiginous malignant melanoma, malignant melanoma, acral lentiginous, melanoma, acral lentiginous malignant
Czech Akrální lentiginózní melanom
Dutch acrolentigineus melanoom
French Mélanome lentigineux des extrémités
German akrales Lentigo-Melanom
Hungarian Acralis lentiginosus melanoma
Italian Melanoma acrale lentigginoso
Japanese 末端部黒子様黒色腫, マッタンブコクシヨウコクショクシュ, マッタンブホクロヨウコクショクシュ
Portuguese Acromelanoma lentiginoso
Spanish Melanoma lentiginoso acro, (M)melanoma acral lentiginoso, maligno, melanoma acral lentiginoso, maligno (anomalía morfológica), melanoma acral lentiginoso, maligno, melanoma maligno lentiginoso acral de la piel (trastorno), melanoma maligno lentiginoso acral de la piel