the melanoma, and will help to define what the final treatment will be. If the melanoma involves the nail fold and the nail bed, complete excision of the nail unit might be required. Final treatment might require wider excision (margins of 0.5 cm or more), digital amputation, lymphangiogram with lymph node dissection, or chemotherapy. Histology The main characteristic of acral lentiginous melanoma is continuous proliferation of atypical melanocytes at the dermoepidermal junction. Other histological signs of acral lentiginous melanoma include dermal invasion and desmoplasia. According to Scolyer et al., ALM "is usually characterized in its earliest recognisable form as single atypical melanocytes scattered along the junctional epidermal layer". Treatment Therapies for metastatic melanoma include the biologic immunotherapy agents ipilimumab, pembrolizumab, and nivolumab; BRAF inhibitors, such as vemurafenib and dabrafenib; and a MEK inhibitor trametinib. Prognosis It has been demonstrated that acral lentiginous melanoma has a poorer prognosis compared to that of cutaneous malignant melanoma (CMM). Society and culture Jamaican musician Bob Marley died of the condition in 1981, aged 36. See also List of cutaneous conditions References Further reading External links Melanoma