JAMA Dermatology

<jats:sec id="ab-dbr230024-4"><jats:title>Importance</jats:title><jats:p>Melanoma in Black individuals has an annual incidence of approximately 1 in 100 000 people. Most studies of melanoma in Black patients have used population databases, which lack important, precise clinical details.</jats:p></jats:sec><jats:sec id="ab-dbr230024-5"><jats:title>Objective</jats:title><jats:p>To identify patient-level and tumor-level characteristics of melanoma in Black patients.</jats:p></jats:sec><jats:sec id="ab-dbr230024-6"><jats:title>Design, Setting, and Participants</jats:title><jats:p>This case series included Black patients with melanoma at 2 tertiary care centers (University of Texas Southwestern [UTSW] Medical Center and Parkland Health), affiliated with a single institution, UTSW in Dallas, Texas. Self-reported Black patients with a histopathologic diagnosis of melanoma were identified between January 2006 and October 2022.</jats:p></jats:sec><jats:sec id="ab-dbr230024-7"><jats:title>Main Outcomes and Measures</jats:title><jats:p>The main variables were demographics, clinical characteristics, personal and family medical history, immunosuppression history, comorbidities, histopathology reports, molecular/genetic studies, imaging reports, melanoma treatments and responses, time to progression, metastatic sites, and survival rates.</jats:p></jats:sec><jats:sec id="ab-dbr230024-8"><jats:title>Results</jats:title><jats:p>A total of 48 Black patients with melanoma (median [range] age at diagnosis, 62 [23-86] years; 30 [63%] female) were included in the study. Of 40 primary cutaneous melanomas, 30 (75%) were located on acral skin, despite only 10 of 30 (33%) being histologically classified as acral lentiginous melanomas. Compared with those with acral disease, patients with nonacral cutaneous melanomas were more likely to be immunocompromised (4 of 10 [40%] vs 2 of 30 [7%]) or have a personal history of cancer (6 of 10 [60%] vs 5 of 30 [17%]), with all 3 patients with superficial spreading melanoma having a history of both. No patients had more than 1 confirmed primary melanoma. Overall, 13 Black patients (27%) with melanoma developed stage IV disease, of whom 12 died because of disease progression. Those diagnosed with advanced acral melanoma, mucosal/ocular melanoma, or melanoma of unknown primary lacked actionable sequence variations, were nonresponsive to immunotherapy, and had the poorest outcomes. No patients with nonacral cutaneous melanomas developed distant metastases or died of melanoma.</jats:p></jats:sec><jats:sec id="ab-dbr230024-9"><jats:title>Conclusions and Relevance</jats:title><jats:p>This single-institution case series highlights several features of melanoma in Black patients that have not been captured in existing population-level registries, including precise anatomic sites, immune status, family and personal cancer history, and genetics. Multi-institutional registries would improve understanding of melanoma in Black patients.</jats:p></jats:sec>

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Prev Chronic Dis

Racial disparities in melanoma survival.

J Am Acad Dermatol

Malignant melanoma in African-Americans: a population-based clinical outcomes study involving 1106 African-American patients from the Surveillance, Epidemiology, and End Result (SEER) database (1988-2011).

Medicine (Baltimore)

Anatomic distribution of malignant melanoma on the non-Hispanic black patient, 1998-2007.

Arch Dermatol

Racial differences in six major subtypes of melanoma: descriptive epidemiology.

BMC Cancer

The CARE guidelines: consensus-based clinical case reporting guideline development.

J Med Case Rep

Risk of nonkeratinocyte skin cancers in people living with HIV during the era of antiretroviral therapy.

J Invest Dermatol

Spectrum of nonkeratinocyte skin cancer risk among solid organ transplant recipients in the US.

JAMA Dermatol

Gender differences in Black patients with melanoma: a retrospective cohort analysis of 2464 cases from the National Cancer Database.

Int J Dermatol

Features of skin cancer in Black individuals: a single-institution retrospective cohort study.

Dermatol Pract Concept

Racial differences in time to treatment for melanoma.

Melanoma and racial health disparities in Black individuals—facts, fallacies, and fixes.

Melanoma in Black individuals has an annual incidence of approximately 1 in 100 000 people. Most studies of melanoma in Black patients have used population databases, which lack important, precise clinical details.
To identify patient-level and tumor-level characteristics of melanoma in Black patients.
This case series included Black patients with melanoma at 2 tertiary care centers (University of Texas Southwestern [UTSW] Medical Center and Parkland Health), affiliated with a single institution, UTSW in Dallas, Texas. Self-reported Black patients with a histopathologic diagnosis of melanoma were identified between January 2006 and October 2022.
The main variables were demographics, clinical characteristics, personal and family medical history, immunosuppression history, comorbidities, histopathology reports, molecular/genetic studies, imaging reports, melanoma treatments and responses, time to progression, metastatic sites, and survival rates.
A total of 48 Black patients with melanoma (median [range] age at diagnosis, 62 [23-86] years; 30 [63%] female) were included in the study. Of 40 primary cutaneous melanomas, 30 (75%) were located on acral skin, despite only 10 of 30 (33%) being histologically classified as acral lentiginous melanomas. Compared with those with acral disease, patients with nonacral cutaneous melanomas were more likely to be immunocompromised (4 of 10 [40%] vs 2 of 30 [7%]) or have a personal history of cancer (6 of 10 [60%] vs 5 of 30 [17%]), with all 3 patients with superficial spreading melanoma having a history of both. No patients had more than 1 confirmed primary melanoma. Overall, 13 Black patients (27%) with melanoma developed stage IV disease, of whom 12 died because of disease progression. Those diagnosed with advanced acral melanoma, mucosal/ocular melanoma, or melanoma of unknown primary lacked actionable sequence variations, were nonresponsive to immunotherapy, and had the poorest outcomes. No patients with nonacral cutaneous melanomas developed distant metastases or died of melanoma.
This single-institution case series highlights several features of melanoma in Black patients that have not been captured in existing population-level registries, including precise anatomic sites, immune status, family and personal cancer history, and genetics. Multi-institutional registries would improve understanding of melanoma in Black patients.

Clinical Features and Outcomes of Black Patients With Melanoma.

Clinical Features and Outcomes of Black Patients With Melanoma

Clinical Features and Outcomes of Black Patients With Melanoma

Clinical Summary

What was studied

Key findings

Study limitations

Clinical implications

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