Background and objective
Acral lentiginous melanoma (ALM) arises in areas that are not generally exposed to UV radiation. Chronic trauma has been hypothesized to play a role in the development of this tumor. The aim of this study was to analyze the association between the presence and characteristics of ALM and location in stress- and non–stress-bearing areas.
Material and methods
Observational, descriptive analysis. For 95 patients with ALM evaluated at Fundación Clínica Vida in Medellin, Colombia between January 2016 and August 2020 we collected demographic, histologic and clinical variables and assigned the patients to 2 groups depending on whether their tumor was located in a stress-bearing area or not.
Ninety-five patients (36 men and 59 women) with a median age of 59 years were studied. ALMs were more common in stress-bearing areas than in non–stress-bearing areas (58 [61%] vs. 17 [17.8%]). A history of direct trauma at the site of the tumor was reported in 18.9% of the cases (p = .025) and was most common in patients with nail lesions. Invasive ALMs in stress-bearing areas had a greater Breslow thickness (p = .006) and higher ulceration rates than those in non–stress-bearing areas (p = .018).
ALM on both the feet and hands is more common in stress-bearing areas. Our findings support the hypothesis that mechanical stress may have a pathogenic role in ALM.