BACKGROUND: Acral melanoma (AM) is still one of the most poorly studied melanomas. It generally presents beyond the fifth decade of life and usually is a BRAF wild-type melanoma. OBJECTIVE: To report the first cases of multiple primary AM in Caucasians. METHODS: Clinical, dermoscopic, pathological and molecular profiles. RESULTS: A healthy 34- year-old male presented an in situ subungual melanoma on his finger, and 22 months later a fast-growing nodular melanoma appeared in an existing nevus on the sole. Both melanomas carried the V600E BRAF mutation. A 19-year-old female patient presented 2 in situ melanomas on different parts of her left foot within a 6-year period of time. The patients have neither familiar melanoma nor germline mutations in CDKN2A/CDK4 genes. CONCLUSION: Multiple AM in Caucasians is very rare. BRAF mutations are possible, especially in a high-risk set of patients with multiple nevi. Specific acral examination must be recommended since AM still suffers delayed detection.
BACKGROUND:Acral melanoma (AM) is still one of the most poorly studied melanomas. It generally presents beyond the fifth decade of life and usually is a BRAF wild-type melanoma. OBJECTIVE: To report the first cases of multiple primary AM in Caucasians. METHODS: Clinical, dermoscopic, pathological and molecular profiles. RESULTS: A healthy 34- year-old male presented an in situ subungual melanoma on his finger, and 22 months later a fast-growing nodular melanoma appeared in an existing nevus on the sole. Both melanomas carried the V600EBRAF mutation. A 19-year-old female patient presented 2 in situ melanomas on different parts of her left foot within a 6-year period of time. The patients have neither familiar melanoma nor germline mutations in CDKN2A/CDK4 genes. CONCLUSION: Multiple AM in Caucasians is very rare. BRAF mutations are possible, especially in a high-risk set of patients with multiple nevi. Specific acral examination must be recommended since AM still suffers delayed detection.
Authors: D Shitara; G Tell-Martí; C Badenas; M M S S Enokihara; L Alós; A B Larque; N Michalany; J A Puig-Butille; C Carrera; J Malvehy; S Puig; E Bagatin Journal: Br J Dermatol Date: 2015-06-19 Impact factor: 9.302