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251,864 patients were included (1453 Black). Black patients had increased odds of acral melanoma (odds ratio [OR] = 27.6, 95% CI] 24.4, 31.2) compared to NHW patients. Black patients still had higher odds ratios of major amputation across all stages after adjusting for acral histology and other potential confounders CONCLUSIONS Increased prevalence of acral melanoma in Black patients does not fully account for increased receipt of major amputation. Nonsurgical caries management techniques (NSCMT) offer a simple, conservative approach to t