What Is Acral Melanoma?

Acral lentiginous melanoma (ALM) is a rare type of skin cancer that makes up about 2 to 3 percent of melanomas. It is the least common type of melanoma. ALM is often called acral melanoma.1

How is acral melanoma unique?

Acral melanoma occurs on the hands and feet – the palms, soles, fingers, toes, and underneath the nails. It is not caused by ultraviolet (UV) rays, as is often the case with other types of melanoma like cutaneous melanoma.1,2

Acral melanoma starts out looking like a patch of discolored skin. If left untreated, the cancerous cells can spread to a larger area of the skin and to deeper layers of the skin tissue. This can happen over the span of several months and years.3

It is not entirely clear what causes acral melanoma. There is some evidence that stress and trauma to the affected area could increase a person’s risk. There may also be a genetic link. More research is needed to understand the true cause.1

Who is at risk?

Both men and women can get acral melanoma. Research shows that acral melanoma is more common as people get older. The average age of someone with acral melanoma is around 63 years old. After age 80, that risk sharply increases.1

Compared to other melanomas, acral melanoma is much more common in non-white populations. In fact, it is the most common skin cancer among people with darker skin.2

Reports show that acral melanoma is the most common type of melanoma in Mexico, China, and Taiwan, whereas it is rare in minority populations in the United States.1

What is the survival rate?

When caught early, acral melanoma can be easily treated. However, because of where acral melanoma is found on the body, (soles of feet, underneath the nail, etc.), it is easy to miss.2

People often do not know they have the disease. Therefore, many people do not seek treatment until it is already at an advanced stage. This may account for the lower survival rate when compared to other types of melanoma. Access to care and education also play a big part in the successful diagnosis and treatment of acral melanoma.1

What are the treatment methods?

Treatment for acral melanoma usually consists of removing the cancerous tissue by cutting it out. Treatment depends on many factors, including:1

  • Size of the affected area
  • Location on the body
  • Stage of the disease
  • Thickness of the acral melanoma (how deep it goes)

In some cases where the acral melanoma is larger, a biopsy is taken to confirm the diagnosis. Surgery is then performed to remove the cancerous tissue. A skin graft, which replaces damaged tissue with healthy tissue, may be needed to close the wound.1,3

In extreme cases, doctors will consider partial removal of a finger or toe. Since amputation can greatly affect a person’s quality of life, a large clinical trial is currently underway to explore other, less invasive options using newer surgical techniques and skin grafts.1

Acral melanoma does not respond as well to radiation as other melanomas. However, there are some chemotherapy options for those with advanced stages of the disease. If acral melanoma is widespread, immunotherapy is an option, with several drugs showing promise.1,2

Awareness and early detection are key

Greater awareness and early detection are very important for people who are at risk for acral melanoma. Education and support from doctors can make all the difference in treating acral melanoma early before it has a chance to spread.1,2

Examine your skin regularly for any signs of changes. See a dermatologist for a yearly skin cancer check.2

Have you or someone you know been diagnosed with acral melanoma? Do you have any questions about ALM? Let us know in the comments!

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