acral lentiginous melanoma

What does Acral Lentiginous Melanoma look like?

Acral Lentiginous Melanoma (ALM) often appears as an unevenly pigmented black or brown spot on the palm or sole that looks different from the rest of the patient's skin and grows over time [3]. In early stages, ALM can be a dark brown or black macule with variegated color, and can become nodular and ulcerated in advanced cases [1].

Key Characteristics:

• Unevenly pigmented
• Black or brown spot on the palm or sole
• Different from the rest of the patient's skin
• Grows over time
• Can be dark brown or black macule with variegated color in early stages
• Can become nodular and ulcerated in advanced cases

Important Notes:

• ALM can be difficult to diagnose due to its rarity and similarity to other skin conditions [5].
• It is essential to consult a medical professional for an accurate diagnosis and treatment plan.

References: [1] - Context result 1 [3] - Context result 3 [5] - Context result 5

Warning Signs and Symptoms of Acral Lentiginous Melanoma

Acral lentiginous melanoma (ALM) is a type of skin cancer that occurs on the palms of the hands, soles of the feet, or under the nails. It's essential to be aware of the warning signs and symptoms of ALM to catch it early and seek medical attention if necessary.

Common Signs and Symptoms:

• A new, darkened streak in a nail (1) [1]
• A changing spot in or connected to a mole on the foot or hand (1) [2]
• Black, gray, tan, or brown mark with irregular borders (3) [3], (8) [4]
• A strip of color appearing under your finger or toenail that isn't caused by an accident or bruise (5) [5]
• A dark spot of skin surrounded by normal skin color with a clear border between the two (6) [6]

Other Possible Signs and Symptoms:

• An oddly shaped black, gray, tan, or brown mark with irregular borders (8) [7]
• A mole that changes size, shape, or color, showing color variations and an irregular border (7) [8]

It's crucial to remember that these signs and symptoms can also be caused by other conditions. If you notice any unusual marks or changes on your skin, it's always best to consult a dermatologist for a proper evaluation.

References: [1] - A new, darkened streak in a nail [2] - A changing spot in or connected to a mole on the foot or hand [3] - Black, gray, tan, or brown mark with irregular borders [4] - An oddly shaped black, gray, tan, or brown mark with irregular borders [5] - A strip of color appearing under your finger or toenail that isn't caused by an accident or bruise [6] - A dark spot of skin surrounded by normal skin color with a clear border between the two [7] - An oddly shaped black, gray, tan, or brown mark with irregular borders [8] - A mole that changes size, shape, or color, showing color variations and an irregular border

Diagnostic Tests for Acral Lentiginous Melanoma

Acral lentiginous melanoma (ALM) can be challenging to diagnose due to its similarity in appearance to other skin conditions. However, several diagnostic tests are used to confirm the presence of ALM.

• Biopsy: A biopsy is a crucial diagnostic test for ALM, where a sample of tissue is removed from the affected area and examined under a microscope by a dermatopathologist (a doctor who specializes in diagnosing diseases by looking at samples of skin, hair, and nails) [1]. This test helps to confirm the presence of cancer cells.
• Dermoscopy: Dermoscopy is a non-invasive diagnostic tool that uses a special magnifying glass or microscope to examine the skin more closely. It can help identify specific features of ALM, such as its pigmentation and growth pattern [8].
• Imaging tests: Imaging tests like X-rays, CT scans, or MRI scans may be used to determine if the cancer has spread to other parts of the body [9].

Early Detection is Key

It's essential to detect ALM early, as it can be more challenging to treat at a later stage. Establishing care with an engaged and dedicated primary care provider (PCP) may improve care and shorten the time it takes to reach an accurate diagnosis [11]. A PCP can help you get specialist referrals, order diagnostic tests, and coordinate providers as you build a healthcare team.

References

[1] Context 1: Diagnosis of acral lentiginous melanoma typically involves a biopsy. [8] Context 8: Dermoscopy is used to examine the skin more closely and identify specific features of ALM. [9] Context 9: Imaging tests may be used to determine if the cancer has spread to other parts of the body. [11] Context 11: Establishing care with an engaged and dedicated primary care provider (PCP) may improve care and shorten the time it takes to reach an accurate diagnosis.

Treatment Options for Acral Lentiginous Melanoma

Acral lentiginous melanoma (ALM) is a type of skin cancer that primarily affects the palms, soles, and mucous membranes. While surgery remains the primary treatment for ALM, drug treatments are also being explored to improve patient outcomes.

Combination Therapies

Recent studies have shown that combination therapies involving anti-PD1 and anti-CTLA4 antibodies can be particularly beneficial for patients with BRAF-mutant ALM [1][2]. These therapies have been shown to enhance the immune system's ability to target cancer cells, leading to improved treatment outcomes.

Targeted Therapies

In addition to combination therapies, targeted therapies such as nivolumab and pembrolizumab have also been investigated for the treatment of ALM [7]. These medications work by targeting specific proteins on cancer cells, thereby inhibiting their growth and spread.

Topical Treatments

In some cases, topical treatments may be used to treat ALM. For example, a combination of 5% imiquimod and tretinoin creams has been shown to be effective in treating pigmented areas affected by ALM [9].

Surgical Treatment

While drug treatments are being explored, surgery remains the primary treatment for ALM. The most common procedure is a wide local excision, which involves removing the tumor and a margin of healthy tissue around it [3]. This approach has been shown to be highly curative for early-stage melanomas.

Clinical Trials

Several clinical trials are currently underway to investigate new treatments for ALM, including trials involving nilotinib and gamma-secretase/notch inhibitors [4][5].

In summary, while surgery remains the primary treatment for ALM, drug treatments such as combination therapies, targeted therapies, and topical treatments are also being explored to improve patient outcomes.

References:

[1] Dugan et al. (2024) - Anti-PD1 and anti-CTLA4 combination therapies have been shown to be particularly beneficial for patients with BRAF-mutant ALM. [2] Dugan et al. (2024) - Anti-PD1 and anti-CTLA4 combination therapies have been shown to enhance the immune system's ability to target cancer cells, leading to improved treatment outcomes. [3] (2024) - The most common procedure for treating ALM is a wide local excision, which involves removing the tumor and a margin of healthy tissue around it. [7] Jung et al. (2022) - Targeted therapies such as nivolumab and pembrolizumab have been investigated for the treatment of ALM. [9] Ingrassia et al. (2024) - A combination of 5% imiquimod and tretinoin creams has been shown to be effective in treating pigmented areas affected by ALM.

Note: The numbers in square brackets refer to the corresponding search results provided in the context.

Differential Diagnosis of Acral Lentiginous Melanoma

Acral lentiginous melanoma (ALM) can be challenging to diagnose, and it is often misdiagnosed as other conditions. The differential diagnosis for ALM includes:

• Benign melanocytic lesions: These are non-cancerous growths that can appear similar to ALM. They include:
  • Acral junctional naevi (AJN) [12]
  • Benign melanocytic nevi [11]
• Other malignant conditions: These are cancerous growths that can be mistaken for ALM. They include:
  • Squamous cell carcinoma [13]
  • Pyogenic granuloma
  • Paronychia
  • Hematoma
  • Onychomycosis (fungal infection of the nail)
  • Ischemic necrosis
• Chronic foot conditions: These are non-cancerous conditions that can be mistaken for ALM. They include:
  • Diabetic foot ulcers [5]
  • Tinea pedis (athlete's foot) [9]
  • Palmoplantar wart

It is essential to consider these differential diagnoses when evaluating a patient with suspected ALM, as early and accurate diagnosis can significantly impact treatment outcomes.

References:

[5] Context 5 [9] Context 9 [11] Context 11 [12] Context 12 [13] Context 13