Acral lentiginous melanoma treated by wide excision with split-thickness skin graft: case in images

  • Joanne Kate M Martinez Southern Philippines Medical Center
  • Diandra Aurora R Zabala Southern Philippines Medical Center
  • Kaitlin Ann T Lim Southern Philippines Medical Center
  • Maricarr Pamela M Lacuesta- Gutierrez Southern Philippines Medical Center
  • Lalaine R Visitacion Southern Philippines Medical Center


Acral lentiginous melanoma (ALM) is the rarest of the four subtypes of cutaneous melanoma. It accounts for only 2-8% of melanomas in caucasians. Only 52 cases of ALM have been recorded in the Philippine Dermatological Society Health Information System from 2011 to 2016. Histopathologic demonstration of cytologic atypia, presence of mitoses in the deep dermis, pagetoid spread of epidermal melanocytes and lack of maturation of nests with descent into the dermis are features diagnostic of melanoma. ALM is primarily managed through wide surgical excision. The most common sites for ALM are the soles, palms, and subungual areas. The rarity of ALM, the inconspicuousness of the locations of some lesions, and the difficulty in discerning ALM from benign lesions and traumatic changes usually delay the diagnosis and contribute to the poor prognosis of the disease.

Aug 31, 2018
Case in images