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Comment. Desmoplastic melanoma is an important subtype of melanoma because it represents a diagnostic pitfall and has a distinct clinical behavior. It has a higher rate of local recurrence and lower incidence of sentinel lymph node involvement than conventional melanoma, especially if the DM is histopathologically pure in appearance. It is of interest that the DMs of the 3 African American women described herein lacked an associated intraepidermal (in situ) melanoma component as well as evidence of solar elastosis, which suggests a cause independent of chronic sun damage. Most melanomas in African Americans are acral tumors or melanomas of superficial spreading type. Based on Surveillance, Epidemiology, and End Results (SEER) data (1992-2002), 7 of 251 primary invasive melanomas of African Americans were reported as desmoplastic. However, they were not further characterized with regard to histopathologic subtype (pure vs mixed) or anatomic site. One case report of a tumor said to be desmoplastic was an acral melanoma. After review of its histopathologic illustrations, we interpret it as a mixed DM. Herein, we report for the first time to our knowledge the occurrence of pure DMs at nonacral sites in African American women.

Skin Cancer Awareness, Attitude, and Sun Protection Behavior Among Medical Students at the University of Miami Miller School of Medicine