| Acral lentiginous melanoma also known as also | | | | discoloration under the nail bed without a history |
| known as subungual melanoma, is a kind of skin | | | | of trauma. Acral lentiginous melanoma is |
| melanoma. Acral lentiginous melanoma is seen on | | | | characterized by lentiginous and some nesting |
| the palms, soles and under the nails. This is the | | | | proliferation of atypical melanocytes. The tumour |
| most common type of malignant melanoma in | | | | has a radial growth phase. Focally, pagetoid spread |
| asians, african and north american blacks, but is | | | | is present, however this is not as prominent as in |
| relatively infrequent in Caucasians. These lesions | | | | superficial spreading melanoma. The melanocytes |
| are usually located on palmar, plantar and | | | | may be surrounded by a halo giving a lacunar |
| subungual skin. Macroscopically, the lesion presents | | | | appearance. It usually starts with a large lesion of |
| as pigmented and ulcerated plaques or nodules. A | | | | 3 cm or larger on the sole of the foot. It looks |
| tendency for this lesion to be expressed in spindle | | | | first like a tan or brown flat stain, appears |
| cell patterns in vertical growth components is one | | | | disorganized with irregular borders. In more than |
| of the distinguishing characteristics. The clinical | | | | 75% of these cases the growth occurs under the |
| features are less striking than in other | | | | big toe or the thumb. Dark skinned patients |
| melanomas, appearing in the radial growth phase | | | | develop this much more often. |
| as macules: dark brown, blue-black, or black, with | | | | Many cases of acral lentiginous melanoma are |
| little variegation and often ill-defined. | | | | significantly more frequent among non-whites and |
| This type of melanoma occurs on non hair baring | | | | the elderly, with the primary lesion, on average |
| surfaces of the body which may or may not be | | | | deeper and ulcerated, without significant |
| exposed to sunlight. It is also found on mucous | | | | differences in the stage or the time elapsed |
| membranes. Acral lentiginous melanoma occurs | | | | between noticing the neoplasia and seeking the |
| predominantly in the sixth, seventh, and eighth | | | | physician. Diagnosis of Acral lentiginous melanoma |
| decades of life, with a peak incidence in the | | | | during the radial growth phase is often difficult, |
| seventh decade for males and in the sixth decade | | | | and it may not be recognized initially, but |
| for females. It also occurs in Caucasians and in | | | | treatment in this phase offers an excellent |
| young people. It does not appear to be linked to | | | | prognosis. Usually, the clinical and pathological |
| sun exposure. It occurs most often in older males | | | | diagnoses are similar, but in cases of thin |
| and often grows slowly over a period of years. | | | | melanomas that are invasive or ulcerated, the |
| The delay in development of the tumor is the | | | | pathological diagnosis will be more reflective of the |
| reason these tumors are often discovered only | | | | true situation. Wide local excision with lymph node |
| when nodules appear or in case of nail | | | | dissection is recommended for subungual |
| involvement, the nail is shed, therefore, the | | | | melanomas measuring more than 1.00 mm and |
| prognosis is poor. | | | | for lesions showing severe regression. |
| The most common sign is a brown or black | | | | |