Acral Melanoma in an Irish Population: Clinicopathological Features, Molecular Profile and Implications for Early Detection.
6 affiliations
- 1Department of Plastic and Reconstructive Surgery, Beaumont Hospital, Dublin 9, Ireland.
- 2Department of Plastic and Reconstructive Surgery, St. Vincent's University Hospital, Dublin 4, Ireland.
- 3School of Medicine, Royal College of Surgeons in Ireland, Dublin 2, Ireland.
- 4Department of Pathology, St. Vincent's University Hospital, Dublin 4, Ireland.
- 5UCD School of Medicine & Medical Sciences, University College Dublin, Dublin 4, Ireland.
- 6Department of Surgery, Beaumont Hospital, Dublin 9, Ireland.
Abstract
Acral melanoma (AM) is a rare, biologically distinct melanoma subtype arising on the palms, soles, and nail apparatus that is frequently diagnosed late and carries a worse prognosis than non-acral cutaneous melanoma. Population-specific AM data remain limited outside North America and East Asia, and Ireland's comparatively homogeneous population has not previously been described. We performed a retrospective, bi-institutional cohort study of 41 AM patients treated at two Dublin tertiary referral centres (2017-2023), using data from prospectively maintained melanoma databases, medical records, and pathology reports. Patients were predominantly older adults (median age 73, range 39-88) with a long delay before presentation: 80.5% reported an enlarging lesion for six months or more before seeking care. Lesions were predominantly located on the foot (73.2%), and acral lentiginous melanoma was the predominant histological subtype (82.9%). Median Breslow Thickness was 3.0 mm, and 75.6% presented with T stage ≥ 3. Amputation was required in 65.9% of patients to achieve adequate margins, 47.4% of those assessed had confirmed nodal disease, and 36.6% developed recurrence. Mutation testing, performed in a subset of tumours, identified BRAF, NRAS, and KIT alterations in a minority of cases, with a substantial proportion classified as triple-wild-type. Despite Ireland's unique germline background reported in cutaneous melanoma, this Irish cohort's mutational profile and advanced stage at presentation were broadly consistent with international cohorts. Earlier clinical recognition, standardised nail-unit biopsy technique, and a national melanoma registry could improve outcomes for this rare, high-risk subtype.
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BibTeX
@article{mcmahon2026acral,
title = {{Acral Melanoma in an Irish Population: Clinicopathological Features, Molecular Profile and Implications for Early Detection.}},
author = {Mary Ellen McMahon and Stephanie M Bollard and John M Keaney and Linda Kelly and Jean Paul Coetser and Silvia Marino and Michael O'Connor and Chloe Spillane and Donal Murphy and Aurelie Fabre and Barry O'Sullivan and Arnold D K Hill and Fiachra Martin and Roisin T Dolan},
journal = {Dermatopathology (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.3390/dermatopathology13040046},
url = {https://europepmc.org/article/MED/42924767},
note = {CC BY},
}
RIS
TY - JOUR
TI - Acral Melanoma in an Irish Population: Clinicopathological Features, Molecular Profile and Implications for Early Detection.
AU - Mary Ellen McMahon
AU - Stephanie M Bollard
AU - John M Keaney
AU - Linda Kelly
AU - Jean Paul Coetser
AU - Silvia Marino
AU - Michael O'Connor
AU - Chloe Spillane
AU - Donal Murphy
AU - Aurelie Fabre
AU - Barry O'Sullivan
AU - Arnold D K Hill
AU - Fiachra Martin
AU - Roisin T Dolan
PY - 2026
DA - 2026/10/01
JO - Dermatopathology (Basel, Switzerland)
DO - 10.3390/dermatopathology13040046
UR - https://europepmc.org/article/MED/42924767
AB - Acral melanoma (AM) is a rare, biologically distinct melanoma subtype arising on the palms, soles, and nail apparatus that is frequently diagnosed late and carries a worse prognosis than non-acral cutaneous melanoma. Population-specific AM data remain limited outside North America and East Asia, and Ireland's comparatively homogeneous population has not previously been described. We performed a retrospective, bi-institutional cohort study of 41 AM patients treated at two Dublin tertiary referral centres (2017-2023), using data from prospectively maintained melanoma databases, medical records, and pathology reports. Patients were predominantly older adults (median age 73, range 39-88) with a long delay before presentation: 80.5% reported an enlarging lesion for six months or more before seeking care. Lesions were predominantly located on the foot (73.2%), and acral lentiginous melanoma was the predominant histological subtype (82.9%). Median Breslow Thickness was 3.0 mm, and 75.6% presented with T stage ≥ 3. Amputation was required in 65.9% of patients to achieve adequate margins, 47.4% of those assessed had confirmed nodal disease, and 36.6% developed recurrence. Mutation testing, performed in a subset of tumours, identified BRAF, NRAS, and KIT alterations in a minority of cases, with a substantial proportion classified as triple-wild-type. Despite Ireland's unique germline background reported in cutaneous melanoma, this Irish cohort's mutational profile and advanced stage at presentation were broadly consistent with international cohorts. Earlier clinical recognition, standardised nail-unit biopsy technique, and a national melanoma registry could improve outcomes for this rare, high-risk subtype.
SN - 2296-3529
ER -