Acral lentiginous melanoma or Hutchinson's melanotic freckle of the extremities. A case report.

An additional category of malignant melanoma of the skin, i.e. acral lentiginous melanoma, has been proposed by some authors. The lesion occurs on the extremities, particularly the soles of the feet, the palms of the hands and the digits, but otherwise has the clinical, histological and prognostic features of Hutchinson's melanotic freckle with melanoma. A case conforming to the description of Hutchinson's melanotic freckle of the sole of the foot occurring in a White patient is described. Reference is also made to previous studies of malignant melanoma of the extremities in Black patients. In 15% of these the histogenetic pattern of Hutchinson's melanotic freckle could be observed in the epidermis, adjacent to the invasive melanoma. This pattern was associated with a very much better prognosis than was the superficial spreading or nodular type. The advisability of introducing a new category of acral lentiginous melanoma is therefore questioned.