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Silva García GA, Sánchez Cárdenas CD, Mendoza Ibarra T, Pérez Martínez CA, Guevara Castillo RM, Pulido Díaz N. Clinical and Histopathologic Features of Subungual Melanoma in 57 Mexican Patients: A 5-Year Cohort Study. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:293-297. [PMID: 37871891 DOI: 10.1016/j.ad.2023.05.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/04/2023] [Accepted: 05/12/2023] [Indexed: 10/25/2023] Open
Abstract
Although subungual melanoma is uncommon, it is associated with worse outcomes than melanomas in other locations and accounts for 1% to 23% of all melanomas, depending on the population. The aim of this study was to describe the clinical and histopathologic features of subungual melanoma in a Mexican population. We identified 303 patients with melanoma, and of these, 19% (57 patients with a median age of 71 years) had subungual melanoma. The main sites affected were the lower limbs (52.6%) and the toe (75.4%). The most common histologic subtype was acral lentiginous melanoma (50.9%). Median Breslow thickness was 3 mm, and stage IA tumors were the most common (in 28.1% of patients). Recurrence and metastasis occurred in 19.3% and 8.8% of patients, respectively. The clinical and histopathologic features identified are similar to those described in the literature. Early diagnosis and treatment are crucial for improving prognosis.
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Affiliation(s)
- G A Silva García
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, México
| | - C D Sánchez Cárdenas
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, México.
| | - T Mendoza Ibarra
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, México
| | - C A Pérez Martínez
- Departamento de Medicina Interna, Hospital General «Ajusco Medio», Secretaría de Salud de México, Estado de México, México
| | - R M Guevara Castillo
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, México
| | - N Pulido Díaz
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, México
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Silva García GA, Sánchez Cárdenas CD, Mendoza Ibarra T, Pérez Martínez CA, Guevara Castillo RM, Pulido Díaz N. [Translated article] Clinical and Histopathologic Features of Subungual Melanoma in 57 Mexican Patients: A 5-Year Cohort Study. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T293-T297. [PMID: 38242433 DOI: 10.1016/j.ad.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/12/2023] [Indexed: 01/21/2024] Open
Abstract
Although subungual melanoma is uncommon, it is associated with worse outcomes than melanomas in other locations and accounts for 1% to 23% of all melanomas, depending on the population. The aim of this study was to describe the clinical and histopathologic features of subungual melanoma in a Mexican population. We identified 303 patients with melanoma, and of these, 19% (57 patients with a median age of 71 years) had subungual melanoma. The main sites affected were the lower limbs (52.6%) and the toe (75.4%). The most common histologic subtype was acral lentiginous melanoma (50.9%). Median Breslow thickness was 3 mm, and stage IA tumors were the most common (in 28.1% of patients). Recurrence and metastasis occurred in 19.3% and 8.8% of patients, respectively. The clinical and histopathologic features identified are similar to those described in the literature. Early diagnosis and treatment are crucial for improving prognosis.
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Affiliation(s)
- G A Silva García
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, Mexico
| | - C D Sánchez Cárdenas
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, Mexico.
| | - T Mendoza Ibarra
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, Mexico
| | - C A Pérez Martínez
- Departamento de Medicina Interna, Hospital General «Ajusco Medio», Secretaría de Salud de México, Estado de México, Mexico
| | - R M Guevara Castillo
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, Mexico
| | - N Pulido Díaz
- Servicio de Dermatología, Centro Médico Nacional «La Raza», Ciudad de México, Mexico
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Tsiogka A, Rubin AI, Gregoriou S, Soulaidopoulos S, Belyayeva H, Rigopoulos D. Prevalence of subungual melanoma in patients with cutaneous malignant melanoma: A systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2024; 38:77-83. [PMID: 37644688 DOI: 10.1111/jdv.19482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 08/09/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Subungual melanoma (SUM) is a rare type of cutaneous malignant melanoma (CMM) associated with poor prognosis, while data regarding its prevalence are scarce. OBJECTIVES We sought to provide a comprehensive systematic review and meta-analysis of the prevalence rates of SUM among all types of CMM, considering certain demographic and clinical characteristics. METHODS The MEDLINE electronic database was searched systematically to identify eligible studies providing prevalence rate estimates of SUM in patients with CMM. Included studies were further analysed to estimate the relative prevalences of SUM according to study design, study years, geographical region and sex distribution. RESULTS Twenty-eight studies met the inclusion criteria. The overall SUM prevalence was 1.9% (95% CI [1.5%-2.3%]). The prevalence of SUM did not differ significantly between population- and hospital-based studies and remained stable over time. However, it was found to be significantly higher in Asians compared to patients of other geographical regions as well as in studies with more men than women compared to those with female preponderance (p < 0.001). CONCLUSIONS In all, the overall SUM prevalence among all subtypes of CMM was estimated at 1.9%, without significant changes over time, and was found to exhibit significant variability between subgroups of different geographical regions.
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Affiliation(s)
- Aikaterini Tsiogka
- Faculty of Medicine, First Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Adam I Rubin
- Department of Dermatology, Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Stamatios Gregoriou
- Faculty of Medicine, First Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Stergios Soulaidopoulos
- First Department of Cardiology, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Helena Belyayeva
- Faculty of Medicine, First Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitris Rigopoulos
- Faculty of Medicine, First Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Human epidermal growth factor receptor 3 serves as a novel therapeutic target for acral melanoma. Cell Death Discov 2023; 9:54. [PMID: 36765036 PMCID: PMC9918519 DOI: 10.1038/s41420-023-01358-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/23/2023] [Accepted: 02/01/2023] [Indexed: 02/12/2023] Open
Abstract
Acral melanoma (AM) is a rare, life-threatening skin cancer. Since AM bears unique features, existing therapies for other types of malignant melanomas have limited effects and the establishment of effective treatments for AM is strongly desired. Human epidermal growth factor receptor 3 (HER3) is a receptor tyrosine kinase that is frequently elevated in tumors and contributes to tumor progression, so it is considered a promising therapeutic target for tumors. This study was established to evaluate the potential of HER3-targeted therapy to treat AM by investigating the expression and function of HER3. HER3 expression was immunohistochemically analyzed in AM lesions of 72 patients and in AM cell lines. To investigate function of HER3, effects of HER3 inhibition on cell proliferation, apoptosis/survival, anchorage-independent growth, and underlying signals were assessed. HER3 was expressed in patients' AM tissues with various intensities and HER3 expression was significantly correlated with patient's disease-free survival. In vitro analyses revealed that HER3 is more highly expressed in AM cells than in normal epidermal melanocytes. AM cells were also shown to be sensitive to the cytotoxic part of a HER3-targeted antibody-drug conjugate. Inhibition of HER3 did not affect cell proliferation, whereas it decreased the anchorage-independent growth of AM cells likely through affecting the nuclear translocation of Yes-associated protein. It is implied that HER3 may serve as a novel therapeutic target for AM.
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Gui J, Guo Z, Wu D. Clinical features, molecular pathology, and immune microenvironmental characteristics of acral melanoma. J Transl Med 2022; 20:367. [PMID: 35974375 PMCID: PMC9382740 DOI: 10.1186/s12967-022-03532-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/13/2022] [Indexed: 11/10/2022] Open
Abstract
Acral melanoma (AM) has unique biology as an aggressive subtype of melanoma. It is a common subtype of melanoma in races with darker skin tones usually diagnosed at a later stage, thereby presenting a worse prognosis compared to cutaneous melanoma. The pathogenesis of acral melanoma differs from cutaneous melanoma, and trauma promotes its development. Compared to cutaneous melanomas, acral melanomas have a significantly lighter mutational burden with more copy number variants. Most acral melanomas are classified as triple wild-type. In contrast to cutaneous melanomas, acral melanomas have a suppressive immune microenvironment. Herein, we reviewed the clinical features, genetic variants, and immune microenvironmental characteristics of limbic melanomas to summarise their unique features.
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Affiliation(s)
- Jianping Gui
- Cancer Center, The First Hospital of Jilin University, 1 Xinmin St, Changchun, 130021, China
| | - Zhen Guo
- Cancer Center, The First Hospital of Jilin University, 1 Xinmin St, Changchun, 130021, China
| | - Di Wu
- Cancer Center, The First Hospital of Jilin University, 1 Xinmin St, Changchun, 130021, China.
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Wang M, Banik I, Shain AH, Yeh I, Bastian BC. Integrated genomic analyses of acral and mucosal melanomas nominate novel driver genes. Genome Med 2022; 14:65. [PMID: 35706047 PMCID: PMC9202124 DOI: 10.1186/s13073-022-01068-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 06/03/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Acral and mucosal melanomas are aggressive subtypes of melanoma, which have a significantly lower burden of somatic mutations than cutaneous melanomas, but more frequent copy number variations, focused gene amplifications, and structural alterations. The landscapes of their genomic alterations remain to be fully characterized. METHODS We compiled sequencing data of 240 human acral and mucosal melanoma samples from 11 previously published studies and applied a uniform pipeline to call tumor cell content, ploidy, somatic and germline mutations, as well as CNVs, LOH, and SVs. We identified genes that are significantly mutated or recurrently affected by CNVs and implicated in oncogenesis. We further examined the difference in the frequency of recurrent pathogenic alterations between the two melanoma subtypes, correlation between pathogenic alterations, and their association with clinical features. RESULTS We nominated PTPRJ, mutated and homozygously deleted in 3.8% (9/240) and 0.8% (2/240) of samples, respectively, as a probable tumor suppressor gene, and FER and SKP2, amplified in 3.8% and 11.7% of samples, respectively, as probable oncogenes. We further identified a long tail of infrequent pathogenic alterations, involving genes such as CIC and LZTR1. Pathogenic germline mutations were observed on MITF, PTEN, ATM, and PRKN. We found BRAF V600E mutations in acral melanomas with fewer structural variations, suggesting that they are distinct and related to cutaneous melanomas. Amplifications of PAK1 and GAB2 were more commonly observed in acral melanomas, whereas SF3B1 R625 codon mutations were unique to mucosal melanomas (12.9%). Amplifications at 11q13-14 were frequently accompanied by fusion to a region on chromosome 6q12, revealing a recurrent novel structural rearrangement whose role remains to be elucidated. CONCLUSIONS Our meta-analysis expands the catalog of driver mutations in acral and mucosal melanomas, sheds new light on their pathogenesis and broadens the catalog of therapeutic targets for these difficult-to-treat cancers.
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Affiliation(s)
- Meng Wang
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
- Helen Diller Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Ishani Banik
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
- Helen Diller Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - A Hunter Shain
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
- Helen Diller Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Iwei Yeh
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA.
- Helen Diller Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA.
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA.
| | - Boris C Bastian
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA.
- Helen Diller Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA.
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA.
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Yin T, Zhao Y, Yang Y, Xu H, Zheng D, Lyu J, Fu G. Nomogram for Predicting Overall Survival in Acral Lentiginous Melanoma: A Population-based Study. Int J Gen Med 2021; 14:9841-9851. [PMID: 34938105 PMCID: PMC8687522 DOI: 10.2147/ijgm.s336443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/01/2021] [Indexed: 12/03/2022] Open
Abstract
Background The objective of this study was to establish a nomogram for predicting the overall survival (OS) of patients with acral lentiginous melanoma (ALM). Materials and Methods The study sample was selected from 1785 patients diagnosed with ALM from 2004 to 2015 in the Surveillance, Epidemiology, and End Results (SEER) database, and R software was used to divide patients into the training cohort and validation cohort at a ratio of 7: 3. Stepwise selection method in the Cox regression model was used in the training cohort to select predictive variables to construct the nomogram, and model validation parameters were used in the validation cohort to evaluate the performance of the nomogram. Results The nomogram showed that age at diagnosis had the greatest impact on OS in patients with ALM, followed by AJCC stage, surgical treatment, SEER stage, sex, race, and marital status. The index of concordance, area under the receiver operating characteristic curve, calibration plots, net reclassification improvement, integrated discrimination improvement, and decision curve analysis demonstrate the good performance of this nomogram. Conclusion The prognostic value of the nomogram is superior to that of the AJCC staging system alone, and it helps clinicians to better predict 3-, 5-, and 8-year OS in patients with ALM.
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Affiliation(s)
- Tingting Yin
- School of Nursing, Jinan University, Guangzhou, People's Republic of China
| | - Yuhui Zhao
- School of Nursing, Jinan University, Guangzhou, People's Republic of China
| | - Ying Yang
- School of Nursing, Jinan University, Guangzhou, People's Republic of China
| | - Huaxiu Xu
- School of Nursing, Jinan University, Guangzhou, People's Republic of China
| | - Dongxiang Zheng
- Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou, People's Republic of China
| | - Jun Lyu
- Clinical Research Department, The First Affiliated Hospital of Jinan University, Guangzhou, People's Republic of China
| | - Guanglei Fu
- Infectious Disease Department, The First Affiliated Hospital of Jinan University, Guangzhou, People's Republic of China
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Serra-García L, Podlipnik S, Bedoya J, Ertekin SS, Manubens E, Carrera C, Zalacain-Vicuña AJ, Malvehy J, Puig S. Dermoscopy training course improves podiatrists' accuracy in diagnosing lesions suggestive of acral melanoma: A cross-sectional study. Australas J Dermatol 2021; 63:e44-e48. [PMID: 34331456 DOI: 10.1111/ajd.13667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/20/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Laura Serra-García
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Sebastian Podlipnik
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Juliana Bedoya
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Sumeyre Seda Ertekin
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Elena Manubens
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Cristina Carrera
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.,Biomedical Research Networking Center on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain
| | - Antonio José Zalacain-Vicuña
- Podiatry School, Faculty of Medicine and Health Sciences, Campus de Ciències de la Salut de Bellvitge, University of Barcelona, Barcelona, Spain
| | - Josep Malvehy
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.,Biomedical Research Networking Center on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain
| | - Susana Puig
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.,Biomedical Research Networking Center on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain
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Susok L, Gambichler T. Caucasians with acral lentiginous melanoma have the same outcome as patients with stage- and limb-matched superficial spreading melanoma. J Cancer Res Clin Oncol 2021; 148:497-502. [PMID: 33856527 PMCID: PMC8800911 DOI: 10.1007/s00432-021-03630-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 04/03/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE Acral lentiginous melanoma (ALM), a relatively rare subtype of cutaneous melanoma, has been reported to have a worse prognosis than other melanomas. We aimed to assess clinical findings in Caucasian ALM patients and compare the data with a matched cohort of superficial spreading melanoma (SSM) patients. METHODS We studied 63 patients with ALM and 63 randomly stage- and limb-matched patients with SSM (non-ALM). In both cohorts, guideline-adjusted diagnosis, treatment and follow-up were performed. RESULTS We did not observe differences in prognostic factors (e.g., tumor thickness, ulceration) between the two cohorts. Both in ALM and non-ALM patients positive sentinel lymph node was a significant independent predictor for disease relapse and melanoma-specific death. However, disease relapse and melanoma-specific death rates did not significantly differ between ALM and non-ALM patients. An overall 5-year melanoma-specific survival of 82.5% and 81% was observed in ALM and non-ALM patients, respectively. CONCLUSIONS Our data confirm that patients with ALM have no worse outcome than non-ALM patients when correcting for significant prognostic factors. Hence, the reportedly high rates of fatal ALM cases should not be ascribed to pathobiological differences between ALM and non-ALM but are most likely are a consequence of a delay in diagnosis and thus advanced stage of ALM.
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Affiliation(s)
- Laura Susok
- Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, Gudrunstrasse 56, 44791, Bochum, Germany
| | - Thilo Gambichler
- Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, Gudrunstrasse 56, 44791, Bochum, Germany.
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Lim SS, Ohn J, Mun JH. Diagnosis of Onychomycosis: From Conventional Techniques and Dermoscopy to Artificial Intelligence. Front Med (Lausanne) 2021; 8:637216. [PMID: 33937282 PMCID: PMC8081953 DOI: 10.3389/fmed.2021.637216] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/19/2021] [Indexed: 12/17/2022] Open
Abstract
Onychomycosis is a common fungal nail infection. Accurate diagnosis is critical as onychomycosis is transmissible between humans and impacts patients' quality of life. Combining clinical examination with mycological testing ensures accurate diagnosis. Conventional diagnostic techniques, including potassium hydroxide testing, fungal culture and histopathology of nail clippings, detect fungal species within nails. New diagnostic tools have been developed recently which either improve detection of onychomycosis clinically, including dermoscopy, reflectance confocal microscopy and artificial intelligence, or mycologically, such as molecular assays. Dermoscopy is cost-effective and non-invasive, allowing clinicians to discern microscopic features of onychomycosis and fungal melanonychia. Reflectance confocal microscopy enables clinicians to observe bright filamentous septate hyphae at near histologic resolution by the bedside. Artificial intelligence may prompt patients to seek further assessment for nails that are suspicious for onychomycosis. This review evaluates the current landscape of diagnostic techniques for onychomycosis.
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Affiliation(s)
| | - Jungyoon Ohn
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea.,Institute of Human-Environment Interface Biology, Seoul National University, Seoul, South Korea
| | - Je-Ho Mun
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea.,Institute of Human-Environment Interface Biology, Seoul National University, Seoul, South Korea
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