24292Array
(
    [TITRE_TRAVAIL] => Array
        (
            [0] => résident
        )

    [etablissement] => Array
        (
            [0] => CHU de constantine
        )

    [nom] => Array
        (
            [0] => boudechiche
        )

    [prenom] => Array
        (
            [0] => lina
        )

    [email] => Array
        (
            [0] => boudechichelina@gmail.com
        )

    [telephone] => Array
        (
            [0] => 0213657449355
        )

    [auteurs] => Array
        (
            [0] => 
 
Nom prénom: boudechiche lina
Email: boudechichelina@gmail.com
Hôpital: CHu de constantine

        )

    [mots_cles] => Array
        (
            [0] => lentiginous, melanoma, retrospective, study;

        )

    [event-id] => Array
        (
            [0] => 3663
        )

    [statut] => Array
        (
            [0] => 1
        )

    [forme] => Array
        (
            [0] => none
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    [abstract] => Array
        (
            [0] => https://www.sotcot.tn/wp-content/uploads/gravity_forms/1-734bfe19ec36a1528718899bf7a2927f/2024/03/ALM.docx
        )

    [user_email] => Array
        (
            [0] => boudechichelina@gmail.com
        )

    [specialite] => Array
        (
            [0] => Chirurgie orthopédique et traumatologique
        )

    [pays] => Array
        (
            [0] => Algérie
        )

    [texte_abs] => Array
        (
            [0] => Early diagnosis, surgical approaches of acral lentiginous melanoma, a retrospective study
Background 
Malignant melanoma represents 1-3% of all malignant tumors. They are divided into four subtypes, based on the growth pattern. Acral lentiginous melanoma (ALM) is the less common (2-3%). It is a histological subtype that occurs in the glabrous skin of the palms, soles, and nails unit. It has the worst prognosis often due to the delayed diagnosis.
The study aims to highlight the importance of early diagnosis and vigilant management. 

Methods and material 
This retrospective study included adult patients who presented ALM of the hand or feet. All patients were addressed by dermatologists. The initial evaluation was clinical which searched for dark pigmentated spots, nodules, or ulcerations on hands or feet. The Clark classification and the Breslow index evaluated the lesions. The biopsy confirmed the histological type. 

Results 
Between 2012 and 2023, 10 cases were recorded,7 females and 3 males. The mid-range age was 59 years old. The left side was implicated in 7 cases. An ALM of the hand was found in 7 cases, and 3 of the feet. There was no metastatic extension. Our patients were phototypes 3 and 4. 
The treatment was surgical, 7 metacarpal exclusions, one foot amputation, one metatarsal exclusion, and one tumor excision, were performed. Only one patient was treated by the BRAF/MEK inhibitors. The survival rate was to a mid-range of 7 years, 6 patients are still alive. 
Discussion 
ALM represents 15% of all melanomas in the Maghreb countries with feminine predominance. The diagnosis is delayed due to the pigmentation of the lesions following the skin markings of the palms and soles. In our series, the diagnosis and the surgical management were at an early stage. The diagnosis was affected at a mid-range of 1.5 years which helped to improve the survival rate to a mid-range of 8 years. 
Exploration of adjuvant therapies, including targeted molecular therapies, may offer additional avenues for improving outcomes.
ALM is a rare subtype. Its treatment consists of surgical excision in the early stages. Early diagnosis aims for adequate treatment and the improvement of prognosis.
        )

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            [0] => 1
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            [0] => 
        )

    [_eael_post_view_count] => Array
        (
            [0] => 17
        )

    [trx_addons_post_views_count] => Array
        (
            [0] => 16
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    [ekit_post_views_count] => Array
        (
            [0] => 16
        )

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        (
            [0] => 0
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