Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan.
Department of Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan.
J Formos Med Assoc. 2024 May;123(5):587-593. doi: 10.1016/j.jfma.2023.10.015. Epub 2023 Nov 22.
The early diagnosis of acral lentiginous melanoma (ALM) contributes to clinical outcomes since ALM can be mistaken for acral melanocytic nevus (AMN). ALM occurrence is reported to correlate with stress-bearing areas, which may assist in differential diagnoses. Our objective is to evaluate the distribution patterns of ALMs and AMNs on the palms and soles among Taiwanese patients.
A retrospective analysis was performed by reviewing the charts of 1400 patients diagnosed with benign and malignant pigmented lesions confirmed after excisional biopsy at our institution between 2000 and 2022 in Taiwan. Correlations between lesions and clinicopathological factors were analyzed.
309 AMNs and 177 ALMs were included. Mechanical stress was significantly associated with plantar ALMs (weight-bearing area: 92.65 %, arch: 7.35 %, P < 0.001). Significant differences in the distribution patterns were observed for plantar ALMs compared with all AMNs (P < 0.001) and non-atypical AMNs (P < 0.001), but were not observed between palmar AMNs and ALMs.
Plantar ALMs were most commonly observed on the weight-bearing areas of the soles, distinct from the distribution of all AMNs and of non-atypical AMNs. The distribution features and anatomic mapping of ALMs may facilitate the early clinical diagnosis of ALM.
肢端雀斑样黑素瘤（ALM）的早期诊断有助于改善临床结局，因为 ALM 可能会被误诊为肢端黑素细胞痣（AMN）。已有报道称 ALM 的发生与承重区域相关，这有助于鉴别诊断。我们的目的是评估台湾患者手掌和足底 ALM 和 AMN 的分布模式。
通过回顾 2000 年至 2022 年在我们机构接受切除活检证实为良性和恶性色素性病变的 1400 例患者的病历，进行回顾性分析。分析病变与临床病理因素之间的相关性。
共纳入 309 例 AMN 和 177 例 ALM。机械性应激与足底 ALM 显著相关（承重区：92.65%，足弓：7.35%，P<0.001）。与所有 AMN（P<0.001）和非典型 AMN（P<0.001）相比，足底 ALM 的分布模式存在显著差异，但与手掌 AMN 无显著差异。
足底 ALM 最常发生在足底承重区，与所有 AMN 和非典型 AMN 的分布不同。ALM 的分布特征和解剖定位有助于 ALM 的早期临床诊断。
