title: Multiple primary acral melanomas in African-Americans: a case series and review of the literature.
abstract: BACKGROUND
  Although melanoma accounts for only 4% to 5% of all skin cancers in the United States, it causes most skin cancer-related deaths. We describe a unique group of African-American patients with multiple primary acral lentiginous melanomas (ALMs).
  
  
  OBJECTIVE
  The purpose of this study was to review the case histories and management of a cohort of patients in the Mohs practice of our dermatologic surgeon with multiple primary ALM.
  
  
  METHODS
  This is a case series of patients with multiple ALM identified by chart review from 2000 to 2005. A thorough review of the literature was performed.
  
  
  RESULTS
  Four patients, all African-American, were identified with multiple ALM. All patients were managed with excision or Mohs micrographic surgery utilizing permanent sections. None of the patients with ALM had melanomas at nonacral sites or other types of skin cancer. Several had acral melanosis. Information in the literature on patients with multiple primary acral melanomas was insufficient.
  
  
  CONCLUSIONS
  Patients with multiple acral melanomas have not, to our knowledge, been reported thus far. It can be extrapolated from current literature, however, that appropriate management of these patients, including staging work and surgical intervention, is to be determined by the individual characteristics of the melanoma and the patient's concomitant risk factors, if any.
authors.affiliation: Department of Dermatology, Medical University of South Carolina, Chareston, South Carolina 29425, USA.
authors.forename: Angela C S
authors.initials: AC
authors.lastname: Hutcheson
authors.forename: Joseph W
authors.initials: JW
authors.lastname: McGowan
authors.forename: John C
authors.initials: JC
authors.lastname: Maize
authors.forename: Joel
authors.initials: J
authors.lastname: Cook
mesh_terms: D001741:Black or African American; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005534:Foot Diseases / Q000208:ethnology* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008545:Melanoma / Q000208:ethnology* / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D015580:Mohs Surgery; D009367:Neoplasm Staging; D012878:Skin Neoplasms / Q000208:ethnology* / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome