INTRODUCTION
Melanoma accounts for only 1% of all skin cancers but is responsible for most skin cancer-related deaths.1 Acral and mucosal melanoma (AMM) accounts for only 4% of all new melanomas but is associated with poorer prognosis.2 Patients of color are disproportionately affected by AMM. Elucidating the clinical, genetic, and environmental features of AMM can guide advancements in their prevention and treatment. Herein we discuss six ethnically diverse cases.
Case Presentations
Case 1
A 48-year-old African American woman presented for evaluation of a black spot on her right thumb that had enlarged over seven years (Figure 1). The patient's past medical history was significant for multiple stab wounds to the right arm over 25 years ago. Physical examination revealed a hyperpigmented, ulcerating plaque on the volar aspect of the right thumb with a central punctum draining clear fluid. Histopathology confirmed the diagnosis revealing Breslow thickness of 2.7 mm, Clark IV (Stage cT3aN0) melanoma. Right axillary sentinel lymph node biopsy demonstrated no signs of lymph node metastasis. The
Case Presentations
Case 1
A 48-year-old African American woman presented for evaluation of a black spot on her right thumb that had enlarged over seven years (Figure 1). The patient's past medical history was significant for multiple stab wounds to the right arm over 25 years ago. Physical examination revealed a hyperpigmented, ulcerating plaque on the volar aspect of the right thumb with a central punctum draining clear fluid. Histopathology confirmed the diagnosis revealing Breslow thickness of 2.7 mm, Clark IV (Stage cT3aN0) melanoma. Right axillary sentinel lymph node biopsy demonstrated no signs of lymph node metastasis. The
lesion was definitively treated with right thumb amputation and close monitoring for disease recurrence.
Case 2
Case 2
A 43-year-old Caucasian woman presented with a pigmented lesion on the left sole. The patient reported a change in color and morphology of the lesion over time, but denied any associated pain, bleeding, or lymphadenopathy. Past medical history was significant for hypertension and the use of tanning beds. A physical exam revealed an irregularly shaped black and brown papule on the plantar aspect of the left foot (Figure 2).
