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Clinical Advances in Hematology & OncologyAcral Melanoma: Clinical Advances and Hope for the Future

Acral melanoma accounts for about 3% of all melanoma cases and has been understudied in clinical trials.

Acral melanoma, a rare subtype of melanoma, presents unique challenges in diagnosis and treatment due to its rarity and distinct biological characteristics. This comprehensive review digs into the current understanding of acral melanoma, from its epidemiology and clinical presentation to the management of both early-stage and advanced disease.

Key Points:
  • It is the most common form of melanoma in patients of Asian, Latin American, and African descent.
  • Diagnosis is often delayed due to misidentification as common ailments like foot ulcers or fungal infections.
  • Treatment principles are largely extrapolated from data on nonacral cutaneous melanoma.
  • Recent trials suggest some efficacy of immune checkpoint inhibitors and targeted therapies, although data are limited.
Additional Points:
  • The etiology of acral melanoma is not well understood, with some studies suggesting a role for traumatic injury.
  • Surgical management often requires complex reconstruction or even amputation.
  • Sentinel lymph node biopsy guidelines are not specific to acral melanoma but may be particularly relevant given its high risk of lymph node positivity.
  • Ongoing research is identifying unique genomic and molecular drivers that may serve as future therapeutic targets.
  • Although acral melanoma remains a challenging subtype to manage due to its rarity and distinct characteristics, emerging data from retrospective studies and ongoing research offer hope for more targeted and effective treatments in the future.

Acral melanoma is the most common form of melanoma in patients of Asian, Latin American, and African descent, accounting for up to 80% of melanoma cases in African patients.

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