Acral lentiginous melanoma (sometimes called acral melanoma) is a rare type of melanoma skin cancer. The word ‘acral’ refers to the peripheral parts of the body. This includes the legs, feet, arms, hands, and nails. In most cases, acral lentiginous melanoma is found on the soles of feet, palms of hands, or under the nails (usually the thumb or big toe).
Find out about acral lentiginous melanoma symptoms (plus see acral lentiginous melanoma images). Know the risk factors and how this type of skin cancer is treated.
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Acral lentiginous melanoma is a rare type of melanoma. It arises when pigment cells (melanocytes) in the outer layer of the skin (the epidermis) grow uncontrollably. Unlike other skin cancers, acral melanoma is not caused by sunlight or UV radiation. It mostly occurs on the hands and feet.
Acral lentiginous melanoma can spread superficially (in a horizontal growth pattern) for months, even years, before becoming invasive. Yet, it can develop quicker than superficial spreading melanoma and Lentigo maligna melanoma.
While anyone can develop acral melanoma, it is most common in darker skins. According to the Cancer Council, this melanoma subtype makes up 1-2% of melanoma diagnoses in Australia.
Acral lentiginous malignant melanoma can look different to other melanoma types. It may also mimic less harmful conditions, such as ulcers, warts, bruises, and fungal infections. This can delay diagnosis and treatment.
Acral lentiginous melanoma symptoms may include:
A flat grey, brown or black lesion with irregular borders
An unexplained brown or black streak in the nail
A changing mole on a hand or foot (including the sole)
Reddish, pinkish or orangish lesion with irregular borders
Changing or growing lesion on the foot or hand
A change in skin texture (such as a thickened patch of skin on the sole or palm)
A lesion that bleeds, itches or is inflamed
Acral lentiginous melanoma may mimic less harmful conditions, such as ulcers, warts, bruises, and fungal infections. This can delay diagnosis and treatment.
These acral lentiginous melanoma pictures show some of the different presentations to watch out for.
Unlike other skin cancers, acral melanoma is not caused by sunlight or UV radiation. It mostly occurs on the hands and feet.
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The cause of this rare melanoma subtype isn’t well understood. But sun exposure doesn’t appear to be a risk factor. Suggested acral lentiginous melanoma causes include genetics, and stress or trauma to the foot.
FACT: In 1981, Bob Marley was diagnosed with acral lentiginous melanoma under his toenail. The singer attributed it to a soccer injury to his foot.
Acral lentiginous melanoma treatment & survival
If diagnosed early, acral lentiginous melanoma can be successfully treated. Acral lentiginous melanoma treatment is primarily based on surgery (excision). In some cases, this may form part of the diagnostic process. The tumour or lesion and a margin of healthy tissue around it is removed.
If the condition has progressed beyond early stage acral lentiginous melanoma, additional treatment may be recommended. Other treatments for acral melanoma may include:
Radiation therapy
High-energy radiation is applied to the tumour to damage the cells and destroy the cancer.
Immunotherapy
If the cancer has spread to other organs, immunotherapy with biologic medicines may be used to target and destroy the cancerous cells.
Targeted therapy
This treatment uses medicines to identify and stop the action of the molecules that are causing the growth of cancer cells.
Chemotherapy
Anti-cancer (cytotoxic) medicines are used to destroy the cancerous cells.
These skin cancer treatments may be used individually or in combination with surgery. The treatment plan is determined by the stage and extent of the cancer.
Wondering about the survival rates for acral lentiginous melanoma? Studies show five-year and 10-year survival rates of 80.3% and 67.5%, respectively. These rates are lower than for other types of melanoma. This may be because this form of cancer has a greater likelihood of misdiagnosis. Its location and the fact it’s more common in darker skin may also delay diagnosis.
Checking the skin for changes is the best way to spot this type (and other types) of melanoma early. As with any form of skin cancer, diagnosing it early is vital for the best outcome.
How do you prevent acral lentiginous melanoma?
The causes of acral lentiginous melanoma are not yet known. As such, there are no known preventative strategies. However, regular skin checks and general sun safety are recommended. If you notice a new or changing lesion on the palms, soles, or under the nails, have it checked out immediately.
Although acral lentiginous melanoma is rare, it can be deadly. Checking the skin for changes is the best way to spot this type (and other types) of melanoma early. As with any form of skin cancer, diagnosing it early is vital for the best outcome.
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