• J H Muchmore, R S Mizuguchi, and C Lee.
• Department of Surgery, Tulane University School of Medicine, New Orleans, LA 70112, USA.
• J. Am. Coll. Surg. 1996 Nov 1; 183 (5): 457465457-65.

BackgroundSince the inception of the Charity Hospital Tumor Registry in 1948, 80 cases of malignant melanoma in blacks were treated at the Tulane University School of Medicine, Department of Surgery. Among black people, melanoma occurs on acral dermal sites. The histologic type is primarily acrallentiginous melanoma (ALM), found on acral, volar-subungual skin and junctional mucocutaneous sites.Study DesignThe registry records of 80 black patients with malignant melanoma were reviewed. The clinical data for 41 female patients were compared to those of 39 male patients. These data were analyzed according to the sex of the patient as well as the histologic type, site, and stage of disease at diagnosis.ResultsAmong women, 44 percent of primary lesions were found on extradermal sites compared with only 10 percent among men. Only 32 percent of primary lesions among women were located on the foot, whereas 73 percent of the primary lesions in men were found on the foot. Of the seven patients with vulvar, cervical, and vaginal melanoma, none lived more than two years after diagnosis. Two female patients with anorectal melanoma succumbed to their disease within 22 months. However, 50 percent of the female patients with head and neck lesions and 75 percent of those with eye lesions lived more than five years. Forty and 26 percent of the female patients with limb lesions lived five and ten years, respectively.ConclusionsBlack females have a higher rate of extracutaneous melanoma than black men or white men and women, which accounts for a distinct negative impact on survival rates among black women with melanoma. In addition, the worst prognosis of melanoma among black women is not entirely related to delays in diagnosis, as has been suggested, but to their higher rates of extracutaneous melanoma.

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