Acral (volar—subungual) melanoma

M. Gutman, J. M. Klausner*, M. Inbar, Y. Skornick, M. Baratz, R. R. Rozin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Acral melanoma occurs in the volar surface of the hands, feet, fingers, toes and subungual sites. Recently it has been recognized as a distinct entity with characteristic clinical and pathological features. Of our 340 patients with malignant melanoma, 24 (7 per cent) had acral melanoma. Sixteen were in the plantar skin, two in the palms and six in the nailbed. The delay in diagnosis was 6 months to 5 years and most of the patients presented with large neglected tumours. Fourteen lesions had histological features consistent with acral lentiginous melanoma — a unique pattern to this area. Fourteen patients were in clinical stage I at diagnosis, seven in stage II and three had distant metastases (stage III). The treatment was mainly surgical. Palmar—plantar lesions were widely excised. One patient underwent below‐knee amputation. Lesions of the digits were treated by amputation of the affected toe. Fourteen of the patients underwent either prophylactic or therapeutic lymph node dissection. In 9 of them, regional metastases were found. In patients with advanced disease chemotherapy was added. Three patients had isolated limb perfusion. Fourteen patients died of metastatic disease within 1–5 years. Four are alive but have metastatic spread. Six patients are disease‐free, one to 4·5 years following diagnosis.

Original languageEnglish
Pages (from-to)610-613
Number of pages4
JournalBritish Journal of Surgery
Issue number8
StatePublished - Aug 1985


  • Malignant melanoma
  • acral lentiginous melanoma
  • surgical treatment
  • volar—subungual melanoma


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