Malignant Melanoma in Pigmented Skin: Does the Current Interventional Model Fit a Different Clinical, Histologic, and Molecular Entity?

Background Although the incidence of malignant melanoma in African Americans is considerably lower than in Caucasians, African Americans have a less‐favorable prognosis related to later presentation and more deeply invasive lesions at diagnosis. Objective To review the current literature addressing the specific clinical, histopathologic, and molecular features of melanoma in darkly pigmented individuals. Methods We reviewed the most up‐to‐date literature pertaining to melanoma in this patient population, including data from clinical studies, epidemiologic analyses, and molecular and genetic studies. Results Several studies have suggested differences between lightly and darkly pigmented populations with regard to clinicopathologic character and the underlying genetic processes affecting its pathogenesis. Conclusion Further investigation is warranted to better elucidate the clinical and underlying biological differences in melanoma between Caucasians and African Americans. Such research may help to ameliorate the disparities in melanoma outcomes through improved screening, public health measures aimed at prevention, and potentially novel targeted therapeutic approaches.