Case Series: Features of Melanoma Among Black Patients in Dallas

By: Chris Schimpf, BS
Posted: Wednesday, February 28, 2024

JAMA Dermatology has published a single-institution case series out of Dallas, highlighting features of melanoma in Black patients, which reportedly have not been captured in existing population-level registries. Citing this lack of precise data, Jennifer G. Gill, MD, PhD, of The University of Texas Southwestern Medical Center (UTSW), Dallas, and colleagues examined patient data including anatomic sites, immune status, family and personal cancer histories, and genetics. They observed that among the cases studied, the poorest outcomes were linked to advanced acral, mucosal, and melanoma of unknown primary, whereas the most favorable outcomes were associated with nonacral cutaneous melanomas. The researchers also reported that Black patients developed melanomas on acral sites at a higher proportion than reported in population-level data and that superficial spreading melanoma was rare, observed only in immunocompromised individuals.

“Large population registries lack the granular data needed to identify potential risk factors for melanoma in Black patients,” the investigators stressed. “Multi-institutional studies and a dedicated registry would improve understanding and outcomes.”

A total of 48 self-reported Black patients with a histopathologic diagnosis of melanoma were included in the study, drawn from two tertiary care centers affiliated with UTSW between January 2006 and October 2022. The researchers reported that of 40 primary cutaneous melanomas, 75% were located on acral skin, despite 33% being histologically classified as acral lentiginous melanomas. They found that patients with nonacral cutaneous melanomas were more likely to be immunocompromised than those with acral disease or to have a personal history of cancer, and that all three patients with superficial spreading melanoma had a history of both. Overall, 27% of patients with melanoma developed stage IV disease, of whom 12 died because of disease progression. No patients with nonacral cutaneous melanomas developed distant metastases or died of melanoma.

Disclosure: For full disclosures of the study authors, visit jamanetwork.com.

JAMA Dermatology