Cutaneous Malignant Melanoma in Skin of Color Individuals

Abstract

Cutaneous malignant melanoma (CMM) is a malignancy with a worldwide incidence. Literature is replete in the Caucasian population, but in skin of color, there is a dearth of literature. Documented reports of the epidemiology of cutaneous melanoma reveal a low incidence in the skin of colour individuals (SCIs). However, this incidence is rising. It is also documented that when CMM does occur, it is commonly acral, unlike in Caucasians in whom it is truncal, and the most common histopathological pattern is acral lentiginous melanoma. There are as yet no observed differences in the histopathology of melanoma in individuals with skin of color and that in Caucasians. SCIs have a low awareness of CMM with consequently advanced lesion presentation, ulcerated lesions, and poor survival compared to Caucasians. The genetics of CMM in the skin of color has not been well studied. The only available study of the genetics of melanoma reveals a difference in melanoma genetics between SCIs and Caucasians. In SCIs, due to the low incidence of cutaneous melanoma, cutaneous melanoma is commonly misdiagnosed. This misdiagnosis can be both clinical and histopathological. Awareness of the features of cutaneous melanoma and sun protection practices is poor in individuals with skin of color. A high index of suspicion should be entertained of any hyperpigmented lesion in any SCI, especially if it is acral and a histopathological assessment should be made as early treatment improves survival.