Acral Lentiginous Melanoma

Acral lentiginous melanoma (ALM) is a type of skin cancer that affects the palms of the hands, soles of the feet, and beneath the nails. In this article, we will provide you with clear and straightforward information about ALM, including its types, causes, symptoms, diagnostic tests, treatment options, and medications.

Types of Acral Lentiginous Melanoma:

  1. Subungual ALM: Occurs under the nails.
  2. Palmoplantar ALM: Affects the palms and soles.

Causes of Acral Lentiginous Melanoma (ALM):

  1. Ultraviolet (UV) Radiation Exposure: Prolonged exposure to sunlight or tanning beds can increase the risk.
  2. Genetic Factors: A family history of melanoma may predispose individuals to ALM.
  3. Skin Type: People with fair skin are more susceptible.
  4. Age: Risk increases with age.
  5. Previous Melanoma: Having a history of melanoma raises the risk.
  6. Immunodeficiency: Weakened immune systems may contribute.
  7. Chemical Exposure: Certain chemicals and toxins can be a factor.
  8. Moles: Having many moles or atypical moles increases risk.
  9. Trauma or Injury: Physical injury to the affected areas may trigger ALM.
  10. Virus Infection: In rare cases, infections like human papillomavirus (HPV) may play a role.
  11. Ethnicity: ALM is more common in people with darker skin tones.
  12. Gender: Slightly more common in men.
  13. Smoking: Smoking tobacco may increase the risk.
  14. Hormonal Changes: Hormonal fluctuations can influence ALM.
  15. Geographic Location: Rates vary by location and sun exposure.
  16. Occupational Exposures: Certain jobs may expose individuals to harmful substances.
  17. Chemicals in Personal Care Products: Some products may contain harmful ingredients.
  18. Existing Skin Conditions: Conditions like psoriasis may contribute.
  19. Radiation Therapy: Previous radiation treatment can be a risk factor.
  20. Obesity: Some studies suggest a link between obesity and ALM.

Symptoms of Acral Lentiginous Melanoma (ALM):

  1. Dark Spots: Irregularly shaped, dark brown or black spots on the palms, soles, or nails.
  2. Changes in Nail: Changes in the shape, color, or texture of the nails.
  3. Pain or Sensitivity: Pain, tenderness, or itchiness in the affected areas.
  4. Ulceration: Development of ulcers or sores on the skin.
  5. Bleeding: Nails may bleed or ooze.
  6. Enlargement: Spots or moles may grow in size.
  7. Irregular Borders: Jagged or uneven borders of skin lesions.
  8. Asymmetry: One half of a lesion doesn’t match the other half.
  9. Evolution: Changes in size, shape, or color of existing moles or spots.
  10. Swelling: Swelling around the affected area.
  11. Spread to Nearby Skin: ALM can spread to surrounding skin tissues.
  12. Lymph Node Enlargement: Swollen lymph nodes in the affected region.
  13. Fatigue: General fatigue and weakness.
  14. Unexplained Weight Loss: Sudden, unintentional weight loss.
  15. Fever: Elevated body temperature without an obvious cause.
  16. Bone Pain: ALM that has spread may cause bone pain.
  17. Respiratory Symptoms: Breathing difficulties if ALM affects the lungs.
  18. Neurological Symptoms: ALM in advanced stages can impact the nervous system.
  19. Gastrointestinal Symptoms: Digestive issues in cases of metastasis.
  20. Vision Changes: Vision problems if ALM spreads to the eyes.

Diagnostic Tests for Acral Lentiginous Melanoma (ALM):

  1. Dermoscopy: A specialized microscope for examining skin lesions.
  2. Biopsy: Removing a small tissue sample for lab analysis.
  3. Imaging: X-rays, CT scans, or MRIs to check for spread.
  4. Lymph Node Biopsy: Checking lymph nodes for cancer cells.
  5. Blood Tests: Assessing blood for tumor markers.
  6. Sentinel Lymph Node Biopsy: Determining if cancer has spread to nearby lymph nodes.
  7. PET Scan: Detecting cancer metastasis in the body.
  8. Skin Mapping: Mapping the affected area for precise treatment.
  9. Genetic Testing: Identifying genetic factors that may influence treatment.
  10. Ultrasound: Using sound waves to examine lymph nodes.
  11. MRI of Brain: If there’s a suspicion of brain metastasis.
  12. Endoscopy: Examining internal organs with a camera.
  13. Bone Scan: Detecting cancer in the bones.
  14. Electromyography (EMG): Evaluating nerve and muscle function.
  15. Immunohistochemistry: Identifying specific proteins in tissue samples.
  16. Tumor Marker Tests: Measuring substances in the blood related to cancer.
  17. Fine Needle Aspiration: Extracting cells from lymph nodes for examination.
  18. Chest X-ray: To check for lung involvement.
  19. Skin Biopsy Stains: Using special stains to identify cancer cells.
  20. Sentinel Node Imaging: Imaging techniques to locate sentinel lymph nodes.

Treatments for Acral Lentiginous Melanoma (ALM):

  1. Surgery: Removing the tumor and surrounding tissue.
  2. Wide Local Excision: Cutting out a margin of healthy tissue around the tumor.
  3. Mohs Surgery: Precise removal of skin layers one at a time.
  4. Lymph Node Dissection: Removing affected lymph nodes.
  5. Skin Grafting: Replacing removed skin with healthy skin from another area.
  6. Radiation Therapy: Using high-energy rays to kill cancer cells.
  7. Chemotherapy: Medications to kill cancer cells throughout the body.
  8. Immunotherapy: Boosting the immune system to fight cancer.
  9. Targeted Therapy: Targeting specific genetic mutations in cancer cells.
  10. Interferon Therapy: Boosting the immune response.
  11. Intralesional Therapy: Injecting medications directly into the tumor.
  12. Topical Chemotherapy: Applying chemotherapy creams or gels.
  13. Cryotherapy: Freezing the tumor with liquid nitrogen.
  14. Laser Therapy: Using lasers to destroy cancer cells.
  15. Photodynamic Therapy: Using light to activate a drug that kills cancer cells.
  16. Electrochemotherapy: Combining electric pulses and chemotherapy.
  17. Watchful Waiting: Monitoring without immediate treatment.
  18. Supportive Care: Managing symptoms and side effects.
  19. Clinical Trials: Testing new treatments through research studies.
  20. Palliative Care: Focusing on comfort and quality of life in advanced cases.

Medications for Acral Lentiginous Melanoma (ALM):

  1. Immune Checkpoint Inhibitors: Pembrolizumab, Nivolumab.
  2. Targeted Therapy: Vemurafenib, Dabrafenib.
  3. Chemotherapy: Dacarbazine, Temozolomide.
  4. Interferon Therapy: Interferon alfa-2b.
  5. Topical Chemotherapy: Fluorouracil (5-FU), Imiquimod.
  6. Supportive Medications: Pain relievers, anti-nausea drugs.

In Conclusion:

Acral lentiginous melanoma is a type of skin cancer that primarily affects the palms, soles, and nails. It can be caused by various factors, including UV radiation, genetics, and skin type. Recognizing its symptoms and undergoing prompt diagnosis through tests like dermoscopy and biopsies is crucial for early detection. Treatment options include surgery, radiation therapy, chemotherapy, immunotherapy, and targeted therapy, often tailored to the individual patient’s needs. Medications like immune checkpoint inhibitors and targeted therapies have shown promise in treating ALM. Consult a healthcare professional for personalized guidance if you suspect or are diagnosed with acral lentiginous melanoma.

 

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. Thank you for giving your valuable time to read the article.

  1. https://medlineplus.gov/skinconditions.html
  2. https://www.aad.org/about/burden-of-skin-disease
  3. https://www.usa.gov/federal-agencies/national-institute-of-arthritis-musculoskeletal-and-skin-diseases
  4. https://www.cdc.gov/niosh/topics/skin/default.html
  5. https://www.skincancer.org/
  6. https://illnesshacker.com/
  7. https://endinglines.com/
  8. https://www.jaad.org/
  9. https://www.psoriasis.org/about-psoriasis/
  10. https://books.google.com/books?
  11. https://www.niams.nih.gov/health-topics/skin-diseases
  12. https://cms.centerwatch.com/directories/1067-fda-approved-drugs/topic/292-skin-infections-disorders
  13. https://www.fda.gov/files/drugs/published/Acute-Bacterial-Skin-and-Skin-Structure-Infections—Developing-Drugs-for-Treatment.pdf
  14. https://dermnetnz.org/topics
  15. https://www.aaaai.org/conditions-treatments/allergies/skin-allergy
  16. https://www.sciencedirect.com/topics/medicine-and-dentistry/occupational-skin-disease
  17. https://aafa.org/allergies/allergy-symptoms/skin-allergies/
  18. https://www.nibib.nih.gov/
  19. https://rxharun.com/rxharun/rxharun/article-types/skin-care-beauty/skin-diseases-types-symptoms-treatment/
  20. https://www.nei.nih.gov/
  21. https://en.wikipedia.org/wiki/List_of_skin_conditions
  22. https://en.wikipedia.org/?title=List_of_skin_diseases&redirect=no
  23. https://en.wikipedia.org/wiki/Skin_condition
  24. https://oxfordtreatment.com/
  25. https://www.nidcd.nih.gov/health/
  26. https://consumer.ftc.gov/articles/w
  27. https://www.nccih.nih.gov/health
  28. https://catalog.ninds.nih.gov/
  29. https://www.aarda.org/diseaselist/
  30. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets
  31. https://www.nibib.nih.gov/
  32. https://www.nia.nih.gov/health/topics
  33. https://www.nichd.nih.gov/
  34. https://www.nimh.nih.gov/health/topics
  35. https://www.nichd.nih.gov/
  36. https://www.niehs.nih.gov
  37. https://www.nimhd.nih.gov/
  38. https://www.nhlbi.nih.gov/health-topics
  39. https://obssr.od.nih.gov/
  40. https://www.nichd.nih.gov/health/topics
  41. https://rarediseases.info.nih.gov/diseases
  42. https://beta.rarediseases.info.nih.gov/diseases
  43. https://orwh.od.nih.gov/

References