Brazen Brett C, Gray Taylor, Farsi Maheera, Miller Richard
Dermatology, Nova Southeastern University - Kiran C. Patel College of Osteopathic Medicine, Palm Harbor, USA.
Dermatology, Largo Medical Center, Largo, USA.
Cureus. 2020 Jun 3;12(6):e8424. doi: 10.7759/cureus.8424.
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.
肢端雀斑样痣黑素瘤（ALM），因其发生部位和组织学生长模式而得名，是黑素瘤的一种罕见变体。ALM出现在手掌、足底或与甲单位相关部位。虽然ALM约占每年诊断出的黑素瘤的5%，但它是在非白种人患者中最常诊断出的黑素瘤亚型，并且最有可能在70岁时被诊断出来。我们报告一例72岁、菲茨帕特里克皮肤类型（FST）为5型的女性患者，她因右足底出现一个缓慢增大的深褐色斑块，伴有色素变化，已存在10年，前来我们诊所就诊。苏木精和伊红（H&E）染色活检显示原位恶性黑素瘤，肢端雀斑样痣型。在此，我们将讨论ALM独特的发病机制，以及其特征性的临床和组织学表现。此外，该病例强调了医生和患者教育的重要性，以提高对这种罕见类型黑素瘤的认识，特别是在有色人种患者中，以期缩短诊断时间并改善预后。
