SLR - June 2016 - Sophia Solomon

Characteristics and Treatment of Cutaneous Melanoma of the Foot

Reference: Nam KW, Bae YC, Nam SB, Kim JH, Choi YJ. Characteristics and Treatment of Cutaneous Melanoma of the Foot. Arch Plast Surg. 2016 Jan; 43(1):59–65.

Scientific Literature Review

Reviewed By: Sophia Solomon, DPM
Residency Program: Wyckoff Heights Medical Center

Podiatric Relevance: Malignant melanoma is the most common cause of death from skin cancer. In East Asia, the foot is the most common area in which malignant melanoma is found. Recently, attention has been drawn to evidence suggesting the etiology of malignant melanoma differs based on body site. This study specifically compares malignant melanoma found on the foot to those found outside of the foot.

Methods: Retrospective review of the medical records of patients who underwent surgical treatment for cutaneous melanoma from September 2000 to January 2015. Subjects were divided into Group A, composed of 52 patients with melanoma of the foot, and Group B, composed of 61 patients with melanoma of sites other than the foot. Age, histopathological subtype, tumor thickness and lymph node invasion were taken into consideration during treatment and analysis of results.

Results: Acral lentiginous melanoma was the most common type of melanoma found on the foot (80.8 percent). Nodular melanoma was the most common type of melanoma found on sites outside of the foot (37.7 percent). Clark level IV was the most common level of invasion in both groups. Comparing lesions by Breslow’s thickness classification, no statistically significant difference was found. No statistically significant difference in survival rate was found between the two groups. No significant differences in sex were found between the two groups. The most common site on the foot that melanoma was found was the heel, and a sural flap was used to treat most of these patients.

Conclusion: The histopathologic subtype of malignant melanoma in the foot differs when compared to other sites of the body. The acral lentiginous subtype is the most common in the foot while nodular melanoma is the most common subtype outside of the foot. Prognosis and survival rate did not differ between the two groups, which is inconsistent with prior research on this topic. 

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