Annals of surgery
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Acral lentiginous melanoma (ALM) is the fourth clinicopathologic variant of malignant melanoma. It occurs on volar surfaces of hands and feet, subungual sites, and fingers or toes. It is characterized by slow lentiginous radial growth and central plaque-like thickening, heavily pigmented tumor cells, markedly thickened papillary dermis, and diffuse reticular infiltration. ⋯ Five-year survivals following all modalities of therapy in 122 patients with Stage I acral melanoma is 63% for planter/palmar lesions, 58% for subungual lesions, and 27% for skin of digits. For the subgroup of Stage I patients with ALM treated by surgery and regional chemotherapy by perfusion, the five-year survival for all sites is 72% and 56% at 10 and 15 years, respectively. Survival in ALM is essentially the same as for all AM lesions.