Acral Lentiginous Melanoma (ALM) is a subtype of melanoma that predominantly affects the acral skin, which includes the palms of hands, soles of feet, and nail beds. Unlike other types of melanoma, ALM is not commonly associated with exposure to sunlight or UV radiation. Instead, it typically occurs in areas not usually exposed to the sun, making it a unique form of melanoma that requires specific attention and understanding.
Unlike other types of cancerous cells, melanocytes produce a pigment called melanin, which is responsible for giving color to our skin, hair, and eyes. When these melanocytes become cancerous, they give rise to melanoma, the deadliest form of skin cancer. While melanoma can occur in any part of the body, such as the skin, eyes, and even internal organs, ALM specifically affects the acral skin.
ALM is considered a rare type of melanoma, accounting for only about 2-8% of all melanoma cases. It primarily affects individuals with a darker complexion, such as those of African, Asian, or Hispanic descent, although it can occur in people of any race or ethnicity. Despite being less common, ALM poses a significant risk due to its tendency to be diagnosed at advanced stages, leading to a poorer prognosis.
One of the reasons ALM is often detected at later stages is its unique characteristics and location. The acral skin is generally more resistant to UV radiation and, therefore, less likely to develop sun-induced skin cancers. As a result, ALM is not closely associated with sun exposure or a history of sunburns. Instead, the exact causes of ALM remain unclear, with researchers suggesting a combination of genetic, environmental, and possibly viral factors playing a role in its development.
The most common manifestation of ALM is a brownish-black lesion or spot that appears on the palms, soles, or nail beds. These lesions may be flat or raised, and they can sometimes resemble benign conditions like a mole or a wart. It is essential to note that not all such lesions are cancerous, but any new or changing spot on the acral skin should be evaluated a dermatologist, especially in individuals at higher risk.
Early diagnosis is crucial in improving the prognosis of ALM. Dermatologists employ various diagnostic techniques, including a thorough clinical examination and dermoscopy, which involves magnified visualization of the lesion’s patterns and structures. In some cases, a skin biopsy may be necessary to confirm the presence of melanoma cells.
The treatment of ALM is similar to other types of melanoma, although there may be some differences in specific approaches due to the unique locations involved. The primary treatment modality is surgical removal of the tumor, along with a margin of healthy surrounding tissue to ensure complete excision. In certain cases, sentinel lymph node biopsy may be performed to assess if the cancer has spread to nearlymph nodes.
In cases where the tumor has spread beyond the primary site or to distant organs, additional treatments may be required. These include adjuvant therapy, such as immunotherapy or targeted therapy, which can help to boost the body’s immune response against cancer cells or specifically target cell mutations driving the tumor’s growth. The choice of treatment depends on various factors, including the stage and extent of the disease, the individual’s overall health, and the presence of any specific genetic mutations.
It is worth highlighting that ALM, like other forms of melanoma, poses a risk of recurrence even after successful treatment. Regular follow-up visits with a dermatologist and ongoing self-examination are important for monitoring any new or changing lesions. By promptly detecting and addressing any suspicious changes, the chances of successful treatment and long-term survival are significantly improved.
Acral Lentiginous Melanoma (ALM) is a specific subtype of melanoma that primarily affects the acral skin, including the palms, soles, and nail beds. It is distinct from other types of melanoma and is more commonly found in individuals with darker skin tones. ALM is not closely associated with sun exposure and can present as brownish-black lesions with unique characteristics. Early diagnosis and treatment are vital for the best outcome, with surgical removal being the primary approach. Additional therapies may be necessary if the disease has spread. Regular monitoring and follow-up are essential to detect any recurrence or new lesions.