Recent advancements in the diagnosis and treatment of acral melanoma

Abstract

Acral melanoma (AM) is the most common histologic subtype of melanoma in dark-skinned patients and is associated with a worse prognosis and a high mortality rate, largely due to the inconspicuous nature of early-stage lesions, which can lead to late diagnosis. Because of the overlapping clinical and histopathological features of AM with other forms of cutaneous melanomas, early detection of AM requires a multidisciplinary approach that integrates various diagnostic modalities, including clinical examination, dermoscopy, histopathology, molecular testing, radiological imaging, and blood tests. While surgery is the preferred method of treatment for AM, other therapeutic options may be employed based on the stage and underlying etiology of the disease. Immune checkpoint inhibitors, molecular targeted therapy, radiotherapy, chemotherapy, and oncolytic virotherapy represent promising advanced treatment options for AM. In this review, we provide an overview of the latest advancements in diagnostic and therapeutic methods for AM, highlighting the importance of early detection and the prompt, individualized management of this challenging disease.

摘要

肢端黑色素瘤(AM)是深色皮肤患者中最常见的黑色素瘤组织学亚型,常伴有更差的预后和高死亡率,主要原因为早期病变的不典型特征导致诊断延误。由于AM的临床和组织病理学特征与其他形式的皮肤黑色素瘤相近,其早期检测需要综合各种诊断模式的多学科方法,包括临床检查、皮肤镜检查、组织病理学检查、分子检测、放射学成像和血液检测。虽然手术是AM的首选治疗方法,但是根据疾病的分期和潜在病因,也可以采用其他治疗方案。免疫检查点抑制剂、分子靶向治疗、放疗、化疗和溶瘤病毒治疗在AM治疗上具有应用前景。在本文中,我们概述了AM诊断和治疗方法的最新进展,强调了早期发现和及时、个性化管理在这一具有挑战性疾病诊疗上的重要性。