Malignant melanoma seen in a tertiary dermatological centre, Singapore.

INTRODUCTION: Primary malignant melanoma is an uncommon skin tumour in Singapore compared with the Western countries. The clinical characteristics of melanoma have been rarely reported in Asians. OBJECTIVES: Our purpose was to study the incidence, clinical characteristics and risk factors of biopsy proven malignant melanoma seen in a tertiary referral skin hospital. METHODS: Case records of patients with histology proven malignant melanoma from January 1989 to December 1998 were retrieved. Patients were interviewed and a complete skin and systemic examination was performed. Data on demographics, histological types, clinical characteristics and risk factors were collated. RESULTS: Between 1989 and 1998, 27 patients were diagnosed with histology proven malignant melanoma. There was a predominance of Chinese with a female to male ratio of 1.3:1. There was a mean lag period of 1.6 years to diagnosing melanoma and there is a general lack of knowledge among the local patients. Most of the lesions (89%) occurred on the extremities. Acral lentiginous melanoma (41%) and nodular melanoma (41%) were the two commonest histologic types. Of the nodular melanomas, 64% were observed in patients below 50 years (64%) while majority of the acral lentiginous melanomas occurred in those above 50 years (91%). In terms of risk factors, we reported a high prevalence of diabetes mellitus with acral lentiginous melanoma. CONCLUSIONS: This study highlighted interesting aspects in terms of clinical characteristics and risk factors in our local patients. It also served as a remainder of the need to raise awareness among the public and medical community of skin cancers or melanomas as they are potentially treatable if detected early.