Several reasons for the worse prognosis associated with acral lentiginous melanoma have been postulated, including differences in mutations and amplifications, such as a lower incidence of BRAF/NRAS mutations,20 a higher incidence of KIT mutations or amplifications,23 and amplification of the TERT gene24 in melanomas classified using the Clark system. The gene discussed is TERT; the disease is acral lentiginous melanoma.