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. 1982 May;195(5):632–645. doi: 10.1097/00000658-198205000-00013

Acral lentiginous melanoma. A clinicopathologic entity.

E T Krementz, R J Feed, W P Coleman 3rd, C M Sutherland, R D Carter, M Campbell
PMCID: PMC1352575  PMID: 7073361

Abstract

Acral lentiginous melanoma (ALM) is the fourth clinicopathologic variant of malignant melanoma. It occurs on volar surfaces of hands and feet, subungual sites, and fingers or toes. It is characterized by slow lentiginous radial growth and central plaque-like thickening, heavily pigmented tumor cells, markedly thickened papillary dermis, and diffuse reticular infiltration. Lesions are unusually large and, in most cases, thick and ulcerated. There were 180 patients with acral melanoma (AM), which includes 67 in whom the specific features of ALM could be documented. One hundren sixty had primary lesions on ;the foot, and 20 occurred on the hand. There were 104 men and 76 women. There were 41 black patients and 139 whites. Five-year survivals following all modalities of therapy in 122 patients with Stage I acral melanoma is 63% for planter/palmar lesions, 58% for subungual lesions, and 27% for skin of digits. For the subgroup of Stage I patients with ALM treated by surgery and regional chemotherapy by perfusion, the five-year survival for all sites is 72% and 56% at 10 and 15 years, respectively. Survival in ALM is essentially the same as for all AM lesions.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arrington J. H., 3rd, Reed R. J., Ichinose H., Krementz E. T. Plantar lentiginous melanoma: a distinctive variant of human cutaneous malignant melanoma. Am J Surg Pathol. 1977 Jun;1(2):131–143. [PubMed] [Google Scholar]
  2. Balch C. M., Murad T. M., Soong S. J., Ingalls A. L., Halpern N. B., Maddox W. A. A multifactorial analysis of melanoma: prognostic histopathological features comparing Clark's and Breslow's staging methods. Ann Surg. 1978 Dec;188(6):732–742. doi: 10.1097/00000658-197812000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Baxter H. MALIGNANT MELANOMA IN THE COLOURED RACES: REPORT OF A CASE ORIGINATING IN THE MOUTH. Can Med Assoc J. 1939 Oct;41(4):350–354. [PMC free article] [PubMed] [Google Scholar]
  4. Braitman M. Subungual malignant melanoma. Cutis. 1979 May;23(5):617–623. [PubMed] [Google Scholar]
  5. CUTLER S. J., EDERER F. Maximum utilization of the life table method in analyzing survival. J Chronic Dis. 1958 Dec;8(6):699–712. doi: 10.1016/0021-9681(58)90126-7. [DOI] [PubMed] [Google Scholar]
  6. Clark W. H., Jr, From L., Bernardino E. A., Mihm M. C. The histogenesis and biologic behavior of primary human malignant melanomas of the skin. Cancer Res. 1969 Mar;29(3):705–727. [PubMed] [Google Scholar]
  7. Clark W. H., Jr, Mihm M. C., Jr Lentigo maligna and lentigo-maligna melanoma. Am J Pathol. 1969 Apr;55(1):39–67. [PMC free article] [PubMed] [Google Scholar]
  8. Coleman W. P., 3rd, Loria P. R., Reed R. J., Krementz E. T. Acral lentiginous melanoma. Arch Dermatol. 1980 Jul;116(7):773–776. [PubMed] [Google Scholar]
  9. DASGUPTA T., BRASFIELD R. SUBUNGUAL MELANOMA: 25-YEAR REVIEW OF CASES. Ann Surg. 1965 Apr;161:545–552. doi: 10.1097/00000658-196504000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. DECKER A. M., CHAMNESS J. T. Melano carcinoma of the plantar surface of the foot; a review of twenty-five cases. Surgery. 1951 May;29(5):731–742. [PubMed] [Google Scholar]
  11. Day C. L., Jr, Sober A. J., Kopf A. W., Lew R. A., Mihm M. C., Jr, Golomb F. M., Hennessey P., Harris M. N., Gumport S. L., Raker J. W. A prognostic model for clinical stage I melanoma of the lower extremity. Location on foot as independent risk factor for recurrent disease. Surgery. 1981 May;89(5):599–603. [PubMed] [Google Scholar]
  12. Day C. L., Jr, Sober A. J., Kopf A. W., Lew R. A., Mihm M. C., Jr, Hennessey P., Golomb F. M., Harris M. N., Gumport S. L., Raker J. W. A prognostic model for clinical stage I melanoma of the upper extremity. The importance of anatomic subsites in predicting recurrent disease. Ann Surg. 1981 Apr;193(4):436–440. doi: 10.1097/00000658-198104000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Feibleman C. E., Stoll H., Maize J. C. Melanomas of the palm, sole, and nailbed: a clinicopathologic study. Cancer. 1980 Dec 1;46(11):2492–2504. doi: 10.1002/1097-0142(19801201)46:11<2492::aid-cncr2820461130>3.0.co;2-j. [DOI] [PubMed] [Google Scholar]
  14. Graham W. P., 3rd Subungual melanoma. Pa Med. 1973 Feb;76(2):56–56. [PubMed] [Google Scholar]
  15. Halperin S. T., Weilbaecher R. G., Correa P., Krementz E. T. Cancer incidence and mortality in Metropolitan New Orleans, 1974-77. Natl Cancer Inst Monogr. 1981 Jun;(57):409–487. [PubMed] [Google Scholar]
  16. Krementz E. T., Carter R. D., Sutherland C. M., Campbell M. The use of regional chemotherapy in the management of malignant melanoma. World J Surg. 1979 Jul 30;3(3):289–304. doi: 10.1007/BF01556579. [DOI] [PubMed] [Google Scholar]
  17. Krementz E. T., Sutherland C. M., Carter R. D., Ryan R. F. Malignant melanoma in the American Black. Ann Surg. 1976 May;183(5):533–542. doi: 10.1097/00000658-197605000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Lewis M. G., Johnson K. The incidence and distribution of pigmented naevi in Ugandan Africans. Br J Dermatol. 1968 Jun;80(6):362–366. doi: 10.1111/j.1365-2133.1968.tb12321.x. [DOI] [PubMed] [Google Scholar]
  19. Lewis M. G. Malignant melanoma in Uganda. (The relationship between pigmentation and malignant melanoma on the soles of the feet). Br J Cancer. 1967 Sep;21(3):483–495. doi: 10.1038/bjc.1967.56. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Pack G. T., Oropeza R. Subungual melanoma. Surg Gynecol Obstet. 1967 Mar;124(3):571–582. [PubMed] [Google Scholar]
  21. Patterson R. H., Helwig E. B. Subungual malignant melanoma: a clinical-pathologic study. Cancer. 1980 Nov 1;46(9):2074–2087. doi: 10.1002/1097-0142(19801101)46:9<2074::aid-cncr2820460928>3.0.co;2-k. [DOI] [PubMed] [Google Scholar]
  22. Petersen N. C. Malignant melanoma of the foot. Scand J Plast Reconstr Surg. 1968;2(2):144–153. doi: 10.3109/02844316809010497. [DOI] [PubMed] [Google Scholar]
  23. Rippey J. J., Rippey E., Giraud R. M. Pathology of malignant melanoma of the skin in Black Africans. S Afr Med J. 1975 May 3;49(19):789–792. [PubMed] [Google Scholar]
  24. Shiffman N., Arndt K. A., Noe J. M. Acral lentiginous melanoma. Ann Plast Surg. 1980 Sep;5(3):232–235. doi: 10.1097/00000637-198009000-00011. [DOI] [PubMed] [Google Scholar]
  25. Søndergaard K., Olsen G. Malignant melanoma of the foot. A clinicopathological study of 125 primary cutaneous malignant melanomas. Acta Pathol Microbiol Scand A. 1980 Sep;88(5):275–283. [PubMed] [Google Scholar]
  26. Taylor D. R., Jr, South D. A. Acral lentiginous melanoma. Cutis. 1980 Jul;26(1):35–36. [PubMed] [Google Scholar]

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