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Furudate K, Kato J, Horimoto K, Sato S, Hida T, Sawada M, Minowa T, Uhara H. Melanoma incidence on the non-weight-bearing areas of the sole. J Dermatol 2024; 51:e241-e242. [PMID: 38345310 DOI: 10.1111/1346-8138.17149] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 07/04/2024]
Affiliation(s)
- Kazuki Furudate
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Junji Kato
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kohei Horimoto
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Sayuri Sato
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tokimasa Hida
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masahide Sawada
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tomoyuki Minowa
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hisashi Uhara
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
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Tsiogka A, Rubin AI, Gregoriou S, Soulaidopoulos S, Belyayeva H, Rigopoulos D. Prevalence of subungual melanoma in patients with cutaneous malignant melanoma: A systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2024; 38:77-83. [PMID: 37644688 DOI: 10.1111/jdv.19482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 08/09/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Subungual melanoma (SUM) is a rare type of cutaneous malignant melanoma (CMM) associated with poor prognosis, while data regarding its prevalence are scarce. OBJECTIVES We sought to provide a comprehensive systematic review and meta-analysis of the prevalence rates of SUM among all types of CMM, considering certain demographic and clinical characteristics. METHODS The MEDLINE electronic database was searched systematically to identify eligible studies providing prevalence rate estimates of SUM in patients with CMM. Included studies were further analysed to estimate the relative prevalences of SUM according to study design, study years, geographical region and sex distribution. RESULTS Twenty-eight studies met the inclusion criteria. The overall SUM prevalence was 1.9% (95% CI [1.5%-2.3%]). The prevalence of SUM did not differ significantly between population- and hospital-based studies and remained stable over time. However, it was found to be significantly higher in Asians compared to patients of other geographical regions as well as in studies with more men than women compared to those with female preponderance (p < 0.001). CONCLUSIONS In all, the overall SUM prevalence among all subtypes of CMM was estimated at 1.9%, without significant changes over time, and was found to exhibit significant variability between subgroups of different geographical regions.
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Affiliation(s)
- Aikaterini Tsiogka
- Faculty of Medicine, First Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Adam I Rubin
- Department of Dermatology, Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Stamatios Gregoriou
- Faculty of Medicine, First Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Stergios Soulaidopoulos
- First Department of Cardiology, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Helena Belyayeva
- Faculty of Medicine, First Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitris Rigopoulos
- Faculty of Medicine, First Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Ren M, Ren J, Cai X, Shen XX, Kong JC, Dai B, Kong YY. Clinicopathological, immunohistochemical and fluorescence in-situ hybridisation features of early subungual melanoma: an analysis of 65 cases. Histopathology 2020; 78:717-726. [PMID: 33065755 DOI: 10.1111/his.14279] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/12/2020] [Accepted: 10/12/2020] [Indexed: 02/03/2023]
Abstract
AIMS Very limited data are available concerning the clinicopathological and molecular features of early subungual melanoma (SM), especially with regard to the Asian population. The aim of this study was to investigate the clinical, histological, immunohistochemical and chromosomal features of early SM. METHODS AND RESULTS Fifty-two in-situ and 13 thin (Breslow thickness ≤1.0 mm) SM cases were retrospectively reviewed. All patients presented with longitudinal melanonychia involving a single digit, and the thumb was the most affected digit (35 of 65, 53.8%). Microscopically, most cases showed small to medium nuclear enlargement (58 of 65) and mild to moderate nuclear atypia (57 of 65). Hyperchromatism and irregular contours of nuclei were persistent features in all cases. The variation of melanocyte count (the number of melanocytes per mm dermal-epithelial junction) ranged from 31 to 255. Intra-epithelial mitoses were identified in 34 cases (52.3%). Statistically, features of in-situ lesions including higher melanocyte count (>70), presence of multinucleated melanocytes, inflammatory infiltrate and cutaneous adnexal extension, were associated with early invasion. Melan-A, human melanoma B (HMB)45, mouse monoclonal melanoma antibody (PNL2) and SOX10 antibodies (>95.0%) showed superior diagnostic sensitivity to S-100 protein (83.1%). Fluorescence in-situ hybridisation (FISH) results were positive in 15 of 23 successfully analysed cases. CONCLUSIONS To the best of our knowledge, this is the largest single-institution study of early SM in an Asian population, and the largest cohort tested by FISH. Early SM mainly showed small to medium nuclear enlargement and mild to moderate nuclear atypia. High melanocyte count, hyperchromatism and irregular contours of nuclei and intra-epithelial mitoses are crucial diagnostic parameters. Immunohistochemistry, especially SOX10 staining, and FISH analysis are valuable in the diagnosis of SM.
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Affiliation(s)
- Min Ren
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jing Ren
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xu Cai
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xu-Xia Shen
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jin-Cheng Kong
- Department of Pathology, First People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Bo Dai
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Yun-Yi Kong
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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Howard M, Xie C, Wee E, Wolfe R, McLean C, Kelly JW, Pan Y. Acral lentiginous melanoma: Clinicopathologic and survival differences according to tumour location. Australas J Dermatol 2020; 61:312-317. [PMID: 32363586 DOI: 10.1111/ajd.13310] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/23/2020] [Accepted: 03/28/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND/OBJECTIVES Acral lentiginous melanoma (ALM) is a melanoma subtype associated with atypical locations on the hands and feet and advanced disease at diagnosis. There is a limited understanding of whether the survival is similar for nail, non-nail, lower limb and upper limb ALM patients. We therefore explored clinicopathologic characteristics and melanoma-specific survival of ALM patients according to tumour location. METHODS A prospectively collected cohort study was performed of all primary invasive cutaneous acral lentiginous melanomas with known thickness and tumour location reviewed at a tertiary referral centre over 21 years. RESULTS A total of 101 ALM patients were reviewed from 1994 until 2016. The majority of cases (82/101) occurred on the feet. Hand ALMs were thicker and more likely to be ulcerated than feet ALMs (P = 0.05 and 0.02, respectively); however, survival was not statistically different between these two groups (univariate HR 0.48 P = 0.11, 95% CI, 0.20-1.17; multivariate HR 0.67 P = 0.40, 95% CI, 0.27-1.69, respectively). Non-nail ALM patients had longer survival when compared to nail ALM on univariate analysis (HR 0.40, 95% CI, 0.17 to 0.90) which was accounted for by Breslow thickness and ulceration (multivariate HR 0.56, 95% CI, 0.24 to 1.34). CONCLUSIONS The reduced melanoma-specific survival in nail ALM patients was likely due to their greater thickness and ulceration. Although hand ALMs are thicker and more frequently ulcerated, this is likely due to the higher proportion of nail ALMs present in this location.
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Affiliation(s)
- Matthew Howard
- Victorian Melanoma Service, Alfred Hospital, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Charles Xie
- Department of Dermatology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Edmund Wee
- Department of Dermatology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Catriona McLean
- Victorian Melanoma Service, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Anatomical Pathology, Alfred Hospital, Melbourne, Victoria, Australia
| | - John W Kelly
- Victorian Melanoma Service, Alfred Hospital, Melbourne, Victoria, Australia
| | - Yan Pan
- Victorian Melanoma Service, Alfred Hospital, Melbourne, Victoria, Australia
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Lee DJR, Arbache ST, Quaresma MV, Nico MMS, Gabbi TVB. Nail Apparatus Melanoma: Experience of 10 Years in a Single Institution. Skin Appendage Disord 2018; 5:20-26. [PMID: 30643776 DOI: 10.1159/000488722] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 03/22/2018] [Indexed: 11/19/2022] Open
Abstract
Background Nail apparatus melanoma (NAM) is rare. The higher mortality reported in the literature is most likely due to advanced disease associated with delayed diagnosis and treatment. Objective All patients diagnosed with NAM were followed at a single reference center during a period of 10 years, with emphasis on dermatological and histological findings. Clinical outcomes were included. Methods A retrospective review of medical records, photographs, and histopathological examination. Results 73.7% of the patients were female and their mean age was 47 years. Caucasian and African-American patients had a similar incidence (47.4%). There was only 1 Asian patient in this study (5.3%). All patients presented with nail plate pigmentation. The mean prediagnosis duration was 33 months. A total of 63.2% patients had in situ melanoma and an average Breslow index of 2.18 mm in invasive cases. Fifteen patients underwent conservative surgery and 3 underwent phalanx amputation. All patients survived, and 4 have had more than a 5-year follow-up. Conclusion In situ lesions showed longitudinal bands or total melanonychia with no nail dystrophy. Invasive cases presented with dystrophic lesions (longitudinal splitting of the nail). Conservative surgery provides a good option without worsening the prognosis. All dermatologists should be aware of early signs of NAM, since prognosis depends on early treatment.
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Affiliation(s)
- Desiree Ji Re Lee
- Department of Dermatology, University of São Paulo, São Paulo, Brazil
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A clinicopathological analysis of 153 acral melanomas and the relevance of mechanical stress. Sci Rep 2017; 7:5564. [PMID: 28717212 PMCID: PMC5514126 DOI: 10.1038/s41598-017-05809-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 06/02/2017] [Indexed: 12/14/2022] Open
Abstract
The pathogenesis of melanomas emerging in plantar surfaces remains unclear; however, mechanical stress has been reported to increase the formation of melanomas. In this study, we conducted a multicenter retrospective analysis of 153 acral melanomas diagnosed between 2000 and 2015 in Taiwan. The male-to-female ratio of the patients in question was 1:1.28, and the mean age at diagnosis was 68 years. We examined whether melanomas which developed in different areas of the patients' soles differed in their associations with various clinicopathological characteristics and survival. Testing by goodness of fit indicated that stress-bearing areas were significantly more conducive to the generation of melanomas than non-stress-bearing areas (P < 0.0001). More specifically, compared to the arch, the rear of the foot and front of the foot were significantly more conducive to the generation of melanomas (P < 0.0001 and P < 0.0001, respectively). The distribution pattern was not associated with differences in age, gender, right/left foot involvement, ulceration, mitosis, lymph node metastasis, tumor thickness, or stage. The overall, distant metastasis-free, and recurrence-free survival rates did not differ significantly between the stress-bearing and non-stress-bearing areas. Furthermore, while acral melanomas tended to develop on stress-bearing areas, the distribution pattern was not associated with the prognostic index or survival.
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