Disparities in Acral Lentiginous Melanoma: More Than a Matter of Timing

Original Article : Disparities in Acral Lentiginous Melanoma: Racial Factors Beyond Delayed Diagnosis

What are the key takeaways of this article?

This population-based study aimed to investigate whether racial disparities in acral lentiginous melanoma (ALM) outcomes are truly due to delayed diagnosis, as commonly assumed. Using data from the Surveillance, Epidemiology, and End Results (SEER) Program, the researchers analyzed melanoma severity at diagnosis and melanoma-specific mortality across racial groups, focusing on four major melanoma histologic subtypes.

The study found that, in contrast to previous assumptions, Black patients with ALM did not present with more severe disease at diagnosis compared to White patients. However, despite similar disease severity, Black patients faced a significantly higher risk of melanoma-specific death (HR: 2.04; 95% CI: 1.31–3.11) compared to their White counterparts. This disparity was unique to ALM, as it was not seen in other major melanoma subtypes.

These findings challenge the prevailing notion that diagnostic delay and socioeconomic factors are the main contributors to poor ALM outcomes in Black patients. Instead, they suggest that biological or systemic differences may play a larger role. The authors call for more research to uncover the mechanisms driving these disparities, including genetic and non-U.S.-based population studies.

Limitations of the study include limited data on racial groups beyond Black and White patients, and lack of international and genetic datasets, which constrain broader conclusions.

Publication Date: August 6, 2026

Reference:

Grant S, Revan D, Tang L, Attwood K, Skitzki J, Paragh G. Disparities in Acral Lentiginous Melanoma: Racial Factors Beyond Delayed Diagnosis. J Am Acad Dermatol. 2025. https://doi.org/10.1016/j.jaad.2025.06.048

Summary By: Megan Lowe