Acral melanoma of the extremities: a study of 33 cases Sarawakian patients.

BACKGROUND Acral melanoma involve the non-pigmented palmoplantar and subungual areas and are commonly seen among Asians. Patients commonly display advanced stage of disease at presentation. It may appear unnoticed and mimic benign lesions. METHODS Data for this retrospective study was retrieved from Histopathology Unit, Sarawak General Hospital, Malaysia archive from 2003 to 2009. RESULT 62.3% cases of malignant melanoma were acral melanoma. The mean age of diagnosis was 64.3 +/- 12.1. The involved sites were the heel (39.4%), middle and frontal plantar area (24.2%), toe (24.2%) and web spaces (9.1%). The clinical presentations were; an enlarging mass (60.6%), non-healing ulcer (24.2%) and abnormal pigmented lesion (15.2%). Most cases exhibited Breslow thickness >4.00 mm (87.9%) and Clark's levels V (50%). The majority showed moderate (non brisk) tumour infiltrating lymphocytes (57.6%). Ulceration (84.8%) and lymphovascular involvement were seen (24.2%). CONCLUSION Acral melanoma is the commonest malignant melanoma in this Sarawakian cohort. Most of the cases presented with advanced stage disease.