Acral Lentiginous Melanoma on the Palm: Unusual Site with a Fatal Outcome

Melanoma is more common in the western countries than among darker pigmented individuals, but acral lentiginous is the most frequently encountered subtype among Indians.

An Indian male presented with a progressively increasing blackish ulcerated nodule on left palm overlying a heterogeneously hyperpigmented macule present since 6 months. A diagnosis of acral lentiginous melanoma was made and a wide local excision with left axillary dissection was done. The patient missed the initial sessions of chemotherapy and succumbed three months later due to metastatic complications.

Melanoma may present with varied morphologies which may resemble benign dermatoses at initial presentation causing a delay in diagnosis. Occurrence of acral lentiginous melanoma on the palm is unusual and may go unnoticed due to its innocuous appearance. The survival rates drop drastically as the tumor metastasizes. Thus, a high index of suspicion is warranted to make a timely diagnosis in an attempt to improve patient outcome.