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Article
Acral Lentiginous Melanoma: A Rare Variant With Unique Diagnostic Challenges
Dermatology
  • Brett Brazen, Nova Southeastern University
  • Taylor Gray, DO, HCA Healthcare
  • Maheera Farsi, DO, HCA Healthcare
  • Richard Miller, DO, HCA Healthcare
Division
West Florida
Hospital
Largo Medical Center
Document Type
Case Report
Publication Date
6-3-2020
Keywords
  • malignant melanoma,
  • cutaneous oncology,
  • dermatology,
  • dermatopathology,
  • genodermatoses
Abstract

Acral lentiginous melanoma (ALM), named for its location and histological growth pattern, is a rare variant of melanoma. ALM presents on palms, soles, or in association with the nail unit. While ALM accounts for approximately 5% of melanomas diagnosed each year, it is the most commonly diagnosed subtype of melanoma in non-Caucasian patients, and it is most likely to be diagnosed in the seventh decade of life. We present a case of a 72-year-old, Fitzpatrick skin type (FST) 5 female who presented to our clinic with a chief complaint of a slowly enlarging dark brown patch with a variation of pigment changes that had been present for 10 years on her right plantar surface. Biopsy obtained for hematoxylin and eosin (H&E) revealed malignant melanoma in situ, acral lentiginous type. Here, we will discuss the unique pathogenesis of ALM, as well as, its characteristic clinical and histological findings. Furthermore, this case underscores the importance of physician and patient education to raise awareness of this rare type of melanoma, specifically in patients with skin of color in hopes of decreasing time to diagnosis and improving prognosis.

Publisher or Conference
Cureus
Citation Information
Brazen B C, Gray T, Farsi M, et al. (June 03, 2020) Acral Lentiginous Melanoma: A Rare Variant With Unique Diagnostic Challenges. Cureus 12(6): e8424. doi:10.7759/cureus.8424