Hall Kelly H., Rapini Ronald P.
University of Texas Health Science Center at Houston
University of Texas McGovern Medical School at Houston
Acral lentiginous melanoma (ALM), also sometimes referred to as, simply, acral melanoma, is melanoma occurring on the hands and feet (palms, soles, fingers, toes, and nail units). The word acral derives from the Greek word referring to the highest or topmost portion of the limbs (extremities). The same stem word is used for the city of Akron (in Summit County, Ohio, the highest elevation on the Ohio and Erie Canal), and the acropolis (the rocky outcrop in Greece on which the Parthenon sits). Lentiginous refers to the initial origin of these tumors as a macular (flat) brown spot, resembling a benign lentigo. The term melanoma refers to a malignancy of melanocytes, the pigment-producing cells in the epidermis. Acral melanoma was first separated as a distinct subtype of cutaneous malignant melanoma (CMM) by Arrington et al. in 1977. It is the least common subtype of melanoma, comprising only 2 to 3% of total melanoma diagnoses. Unlike other CMM, UV-radiation is not thought to play a significant part in the development of ALM. It is most commonly on the lower extremities and is often advanced at the time of presentation leading to a high level of morbidity and mortality. It has a higher proportional incidence in non-white populations compared to other subtypes of melanoma. In this article, we will discuss the unique aspects of this disease.
肢端雀斑样痣黑色素瘤（ALM），有时也简称为肢端黑色素瘤，是发生于手和脚（手掌、足底、手指、脚趾及甲单位）的黑色素瘤。“肢端”一词源于希腊语，指肢体（四肢）的最高或最顶端部分。俄亥俄州阿克伦市（位于萨米特县，是俄亥俄和伊利运河的最高点）以及雅典卫城（希腊境内帕特农神庙所在的岩石露头）的名称中也使用了相同的词根。“雀斑样痣的”指这些肿瘤最初起源于一个斑状（扁平）褐色斑点，类似于良性雀斑。“黑色素瘤”一词指黑色素细胞的恶性肿瘤，黑色素细胞是表皮中产生色素的细胞。1977年，阿林顿等人首次将肢端黑色素瘤作为皮肤恶性黑色素瘤（CMM）的一种独特亚型区分出来。它是黑色素瘤最不常见的亚型，仅占黑色素瘤总诊断病例的2%至3%。与其他CMM不同，紫外线辐射被认为在ALM的发生发展中不起重要作用。它最常见于下肢，且在出现时往往已处于进展期，导致高发病率和死亡率。与黑色素瘤的其他亚型相比，它在非白人人群中的发病率比例更高。在本文中，我们将讨论这种疾病的独特之处。
