• Vol. 41 No. 1, 17–20
  • 15 January 2012

Melanoma: Differences between Asian and Caucasian Patients



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Introduction: Cutaneous melanoma is rare in Asia and the clinical presentation and outcome of melanoma is not well described in Southeast Asia. In addition, it is unclear if ethnic variations exist between the various racial groups. The objective of our study is to present the clinical characteristics of melanoma in Singapore and to highlight ethnical differences between Asians and Caucasians living in Singapore.

Materials and Methods: Data were retrospectively collected from 48 patients with histological confirmation of melanoma who were seen in both the National Skin Centre and National Cancer Centre of Singapore.

Results: Acral lentiginous melanoma (ALM) was the most common subtype of melanoma in Singapore (50%). A higher proportion of non-ALM subtypes of melanoma compared to ALM were diagnosed at stage 1 (48% vs. 25%). The delay in diagnosis of ALM was 27 months compared to 12 months in other subtypes. Compared to Caucasians, there was a trend towards Asian patients being older, having a higher proportion of ALM and a longer delay to diagnosis.

Conclusion: Geographical and ethnic variations in the clinical presentation of melanoma exist. Specially adapted programmes are necessary to increase awareness of the different clinical presentation of melanoma in Asia and to encourage examination of the palms and soles in order to reduce the delay in diagnosis.

Cutaneous melanoma is the most common cause of mortality amongst skin cancer in Caucasian populations and incidence rates per 100,000 patient years vary between 21.9 in the United States to 55.9 in Australian males. In contrast, the incidence of melanoma in Asia is significantly lower with incidence rates of 0.2 to 0.5 per 100,000 patient years. In addition, the most common histological subtype in Asians is acral lentiginous melanoma (ALM) which accounts for approximately 50% of all cases, compared to Caucasians populations where it constitutes only 2% to 3% of all cases.

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