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Malignant Melanoma
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Cutaneous melanomas can be categorized on the basis of their macroscopic appearance: Superficial spreading (70% cases), nodular (20%), acral lentiginous (5%), and lentigo maligna melanoma (5%). Superficial spreading melanoma often arises as a dark area within a pre-existing junctional nevus. Nodular melanoma typically arises from apparently normal skin and is aggressive. They are usually darker than superficial spreading melanoma, uniform in color, and often dome-shaped. Rarely, nodular melanomas are amelanotic. Acral lentiginous melanoma affects the palms, soles, and nail beds. They are more common in darker skinned individuals. Lentigo maligna melanoma tends to occur on the face or neck of older patients and has a better overall survival.
Melanoma-associated emergencies
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
Vidya Kharkar, M. R. L. Sujata
SSMM is by far the most common clinical subtype of melanoma in white skin and accounts for approximately 70% of cases diagnosed. In contrast, acral lentiginous melanoma is the least common subtype in white patients, more often seen in patients with African American skin types.
Skin and soft tissue
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
Acral lentiginous melanoma (ALM) comprises 2%–8% of melanoma in White patients but up to 60% in dark-skinned patients. In the former group, it usually affects the elderly (>60 years) with lesions most commonly found on palms, on soles, on mucocutaneous junctions and in subungual locations (black streaks in nails – melanonychia). Radial growth is followed by vertical growth after ~2 years. It is histologically similar to LMM but is more locally aggressive and more likely to metastasise.
The efficacy of platinum-based chemotherapy for immune checkpoint inhibitor-resistant advanced melanoma
Published in Acta Oncologica, 2019
Takuya Maeda, Koji Yoshino, Kojiro Nagai, Satoe Oaku, Megumi Kato, Azusa Hiura, Hiroo Hata
Several studies have addressed the treatment of ICI-resistant melanoma, but no standard treatments are available. Blasig et al. described the reinduction of PD-1 inhibitor therapy after the failure of ICI therapy [10]. In their study, eight advanced melanoma patients who had already experienced ICI therapy were subsequently retreated with PD-1 inhibitor for a median of 2.5 months. As the best response in their cohort, one patient (12.5%) achieved PR and three patients (37.5%) had SD. In addition, Fujisawa et al. reported that the response rate to ipilimumab therapy after the failure of nivolumab therapy was only 3.6%; nevertheless, severe irAEs occurred in more than half of the participants [4]. Intriguingly, their study of 67 patients included 20 mucosal and 20 acral lentiginous melanoma patients. Other reports also indicated that the response rate and survival time were worse for mucosal and acral lentiginous melanoma than for other subtypes [11, 12]. The responses to ICIs in mucosal and acral lentiginous melanoma patients were also poor in our study; however, the response to chemotherapy tended to be relatively favorable. In the responses of four cases with controlled disease, one mucosal melanoma patient and one acral lentiginous melanoma patient achieved PR, and two mucosal melanoma patients had SD.
Skin cancer awareness and sunscreen use among outpatients of a South African hospital: need for vigorous public education
Published in South African Family Practice, 2018
NC Dlova, R Gathers, J Tsoka-Gwegweni, RJ Hift
Given the protective pigmentation, the incidence is substantially lower in black Africans. Incidence rates between 0.9 and 1.2 per 100 000 among black South Africans have been reported.7,8 However, the advantage of this is offset by a tendency to late presentation. Some 70% of melanomas in black Africans are reported to be on the lower limbs, with 90% of those being below the ankle, with acral lentiginous melanoma being the most common subtype.3,9 The plantar, subungual and mucosal surfaces are common sites for melanoma in black South African patients.3,10 Whereas 71–74% of melanomas in the white South African population have been reported to have Breslow thickness < 1.5 mm,5 black patients present with significantly higher Breslow thickness depths.11 Survival rates of plantar melanoma in black patients are very low—only 25% of a sample of 40 black African patients with plantar melanoma survived five years.11 The South African melanoma data parallel US SEER (Surveillance, Epidemiology, and End Results Program) data in terms of the race-correlated differences in both incidence and thickness depth at presentation.4,12,13 In the USA African-Americans are more likely to present with advanced disease and to have a worse prognosis than white individuals.14
Association of TRF2 expression and myeloid-derived suppressor cells infiltration with clinical outcome of patients with cutaneous melanoma
Published in OncoImmunology, 2021
Marius Ilié, Elisabeth Lantéri, Emmanuel Chamorey, Brice Thamphya, Marame Hamila, Henri Montaudié, Alexandra Picard-Gauci, Sophie Gardrat, Thierry Passeron, Sandra Lassalle, Elodie Long-Mira, Julien Cherfils-Vicini, Eric Gilson, Véronique Hofman, Paul Hofman
Of the 125 patients included for analysis, 41 (32.8%) were female and 84 (67.2%) were male patients. Overall median age was 64.2 y (range, 23–92 y). A majority of patients had an ECOG status equal to 0 (97, 77.6%). Of the 125 cases, superficial spreading malignant melanoma accounted for 44.8%, nodular melanoma 25.6%, acral lentiginous melanoma 4.8%, invasive lentigo maligna melanoma 4%, and 20.8% of the cases were not classified. 32% of the cases harbored a BRAF mutation on exon 15.