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It can’t be melanoma: I’m black.

You should be suspicious of any changing spot on your skin, even if you are a person of color. 

Many patients will think that a spot that I am concerned about cannot be a melanoma because they have brown or black skin.  While melanoma is by far more common in whites, this deadly skin cancer does occur  in  Hispanics, African-Americans, Asians, Pacific Islanders and Native Americans.

Delayed diagnosis leads to worse survival

Unfortunately, because melanoma is unusual and unexpected in non-whites, this cancer may be missed and the diagnosis may be made at a later stage when survival is worse ( http://dx.doi.org/10.1016/j.jaad.2016.06.006).   Early detection is the key to survival.  We want to catch  melanomas when they are early and thin.  Thicker melanomas are more likely to spread and to kill.

Acral lentiginous melanoma

Melanomas in people of color tend to occur in covered areas of the skin which are not typically exposed to the sun.

acral-lent-mmA form of melanoma called “acral lentiginous melanoma” occurs on the palms, soles, and under the nails in both whites and non-whites.  While this form of melanoma is rare, it is the most common type of melanoma that occurs in people of color.

 

 

 

Case in point:  Bob Marley

bob-marleyBob Marley was the great Jamaican Reggae singer and songwriter.  He died of melanoma in 1981 when was only 36 years old.

In 1977, Marley developed a dark spot under his toenail after a soccer injury.  A diagnosis of melanoma was made after a period of time during which the injury did not heal.  Amputation of the toe was recommended.  However, because of his Rastafarian religion, he refused amputation.  The melanoma metastasized and killed him within 4 years of the diagnosis (http://worldmusic.about.com/od/genres/f/BobMarleyDeath.htm).

Bottom line:

Look at your feet and nails.  Be sure to evaluate any new or changing spots.

 

Harry Goldin, M.D.

 

 

 

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