Acral lentiginous melanoma: a variant of malignant melanoma of special interest in Colombia

Abstract

Acral lentiginous melanoma (ALM) is a rapidly progressive variant of malignant melanoma (MM). It constitutes 5-10% of all cases of MM and its prevalence is higher in blacks, Asians and Latin Americans. In Colombia, the incidence of MM is increasing and ALM is one of its most common variants (14.7% of all melanoma cases). The mean age at presentation of the disease is 58 years, and the survival rate is lower in black people, partly due to delayed diagnoses. ALM is located in the soles, palms and subungual regions. Mutations in several genes have been described in the pathogenesis of ALM, namely: 9p21 (p16: 67%), 11q13 (CCND1) (47%), 22q11-q13 (40%) and 5p15 (20%). The diagnosis of ALM has been traditionally based on histopathology; however, other diagnostic tools such as dermoscopy, evaluation of the sentinel lymph node and detection of alterations in proteins that control the cell cycle, may contribute to earlier diagnoses and, consequently, improve the prognosis of both ALM and MM.