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Acral melanocytic lesions more likely in skin-of-color patients

Acral melanocytic lesions were common on the palms and soles of dermatology patients, particularly in patients with skin of color and darker Fitzpatrick skin types, according to recently published study results.

Researchers conducted a prospective cohort study by examining the palms and soles of 1,052 patients (59% female; mean age, 49.6 years) presenting between October 2013 and April 2015 at outpatient dermatology clinics in New York and Miami. Clinical and dermoscopic photographs of any lesions present were taken. Patients with skin of color made up 54.6% of the patients studied, which included Hispanic (37.5%), black (11%) and Asian (6%). The remaining patients (43.6%) were non-Hispanic white.

There were 379 patients (36%) with 669 acral pigmented lesions, including 391 lesions on the palms and 278 on the soles. Patients with skin of color were more likely to have acral melanocytic lesions compared with non-Hispanic white patients (40% vs. 30%; P < .01). The difference was more noted in the lesions of the palms, compared with lesions on the soles.

It also was more common for patients with Fitzpatrick skin types IV to VI to have an acral pigmented lesion (44%) compared with patients with Fitzpatrick skin types I to II (28%; P < .01).

There was a correlation between acral melanocytic lesions and increased mole counts, especially on non-Hispanic white patients. Benign dermoscopic patterns were demonstrated in the majority of lesions. Two lesions had a parallel ridge pattern and were found to be atypical nevi on biopsy specimen.

There were 54% of patients with a melanocytic lesion on their palms and 43% of patient with melanocytic lesion on the soles who reported awareness of the lesions.

 “Although acral melanoma is an uncommon subtype, diagnosis and management for acral pigmented lesions presents a particular challenge for clinicians,” the researchers concluded. “We found that acral lesions were prevalent in our cohort, particularly among skin-of-color patients, with the overwhelming majority of lesions demonstrating benign demoscopic patterns. Although the use of screening skin-of-color individuals for lesions on their acral sites is questionable, our data corroborate the importance of dermoscopy in characterizing the patterns of lesions and point to the need for patient education in monitoring these lesions.”  – by Bruce Thiel

Disclosure: Madankumar reports no relevant financial disclosures. Please see the full study for other researchers’ relevant financial disclosures.