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Most Melanomas in Black Patients Located on Acral Skin

Patients with nonacral cutaneous melanomas more likely to be immunocompromised, have personal history of cancer

By Dermsquared Editorial Team | January 24, 2024

WEDNESDAY, Jan. 24, 2024 -- Among Black patients, most melanomas are located on acral skin, according to a study published online Jan. 24 in JAMA Dermatology.

Sophia N. Wix, from the University of Texas Southwestern Medical Center in Dallas, and colleagues identified patient- and tumor-level characteristics of melanoma in Black patients in a case series conducted at two tertiary care centers affiliated with a single institution. Data were included for 48 Black patients (median age at diagnosis, 62 years).

The researchers found that 30 of the 40 primary cutaneous melanomas were located on acral skin, although only 10 of these 30 were histologically classified as acral lentiginous melanomas. Patients with nonacral cutaneous melanoma were more likely to be immunocompromised (40 versus 7 percent) or have a personal history of cancer (60 versus 17 percent) than those with acral disease; all three patients with superficial spreading melanoma had a history of both. None of the patients had more than one confirmed primary melanoma. Overall, 27 percent of Black patients with melanoma developed stage IV disease; 12 of these 13 patients died due to disease progression. None of the patients with nonacral cutaneous melanomas developed distant metastases or died of melanoma. Patients with advanced acral melanoma, mucosal/ocular melanoma, or melanoma of unknown primary did not have actionable sequence variations, were not responsive to immunotherapy, and had the worst outcomes.

"Focusing research efforts to improve therapeutic and prevention strategies for these poorly studied subtypes has potential to improve melanoma mortality in Black patients," the authors write.


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