Clinical Characteristics of Melanoma in Black Patients Identified

Gorodenkoff/AdobeStock

A study at University of Texas Southwestern Medical Center (UTSW)–affiliated hospitals investigated and identified the characteristics of melanoma in Black patients, who represent an understudied population.¹

Melanoma among Black individuals is relatively rare, with an annual incidence of 1 in 100,000 in the US. Yet large population-registry-based studies have failed to provide detailed data on melanoma in this segment of the population, which prompted the researchers to conduct a case series report.

“We wanted to look closely at these cases in the hopes of garnering clues about risk factors for melanoma in this population,” senior author Jennifer Gill, MD, PhD, told Dermatology Times.

The report appeared in JAMA Dermatology on January 24.

UTSW–affiliated hospitals serve a diverse population, the researchers noted, including the approximately 1.2 million Black residents of Dallas-Fort Worth, providing a unique opportunity.

The retrospective case series included 48 Black patients diagnosed with melanoma between January 2006 and October 2022. The patients’ median age at diagnosis was 62 years, and 63% were female.

In this group, 75% of cutaneous melanomas occurred in acral areas, a higher proportion than reported in population-level data, according to Gill and colleagues. For the purposes of this research, acral sites were defined as feet and hands, including nails. Nonacral sites included all other nonmucosal cutaneous sites.

Nonacral cutaneous melanomas were seen more often in those patients who were immunocompromised or who had a personal history of other cancers, or both, the researchers found. Those patients with nonacral cutaneous melanomas had the most favorable outcomes.

Superficial spreading melanomas (SSM) were rare and observed only in patients who were immunocompromised and had a history of other types of cancer. 

The poorest disease outcomes were among patients with advanced acral melanoma; mucosal or ocular melanoma; or melanoma of unknown primary (MUP). A total of 13 patients (27%) with melanoma developed stage IV disease, of whom 12 died because of disease progression.

In an earlier study, researchers at NYU Langone Health in New York City reported on more than 381,000 patients from the Surveillance, Epidemiology and End Results (SEER) registry. They analyzed the association between melanoma specific survival and race before 2000, between 2000 and 2009, and in 2010 and beyond.²

These researchers found patients who were Hispanic, Black, and Asian and Pacific Islander suffered worse disparities in melanoma survival from before 2000 to 2010 and after.³

This study also found that Black patients were more likely than other racial groups to have acral lentiginous melanoma. Racial and ethnic minority patients also had a higher percentage of mucosal melanoma than White patients.

“Although large databases are important, we need more granular studies to address ongoing questions,” Gill told Dermatology Times.

“For example, how does melanoma present in most Black patients? Who should we be screening? What subtypes lead to the highest morbidity and mortality in this population and how can we improve outcomes? Although this is a single institution study, some early clues are emerging. My hope is that we can extend this work beyond UTSW so that we can make more definitive conclusions and better counsel patients and physicians in the future,” Gill said.

What is your experience in treating melanoma in Black patients? Share your clinical insights with colleagues in Dermatology Times by sharing article proposals via PTEditor@mmhgroup.com.

References

1. Wix SN, Brown AB, Heberton M, Adamson AS, Gill JG. Clinical features and outcomes of black patients with melanoma. JAMA Dermatol. Published online January 24, 2024. doi:10.1001/jamadermatol.2023.5789
2. Qian Y, Johannet P, Sawyers A, Yu J, Osman I, Zhong J. The ongoing racial disparities in melanoma: an analysis of the Surveillance, Epidemiology, and End Results database (SEER) database (1975-2016).Journal of the American Academy of Dermatology (2020).doi: https:// doi.org/10.1016/j.jaad.2020.08.097
3. Hilton L. Racial disparities persist, worsen in melanoma survival. Dermatology Times. October 2, 2020. Accessed January 30, 2024. https://www.dermatologytimes.com/view/racial-disparities-persist-worsen-in-melanoma-survival