Follow-up data (over a 3-year period) and the histological appearances of 
primary lesion were studied and related in 40 Black patients with malignant 
melanoma. This to our knowledge is the first study in Black African patients. It 
was found that they present with large deeply invasive lesions, particularly on 
the foot. The prognosis is poor, with an over-all 3-year survival rate of 35%. 
The histological features used to assess the prognosis of malignant melanoma in 
Whites, that is histogenetic pattern, size and shape of the lesion, level of 
invasion, presence of ulceration and mitotic activity would seem to be equally 
applicable in Black patients. In addition, marked cellular pleomorphism, 
haemorrhage, necrosis and fibrosis within the tumour are bad signs. In this 
series lymphocytic infiltration, either within the tumour or at the edge, 
possibly indicative of an immune response, seemed to be of favourable prognostic 
import. Surprisingly, a lesion histologica-ly that of lentigo maligna melanoma 
was found on the feer of some blacks and could be related to much more 
favourable survival figures.