Skin Disorders
Bookmark and Share
   Abscess
   Acne
   Acquired Melanocytic Nevocellular Nevi
   Acral Lentiginous Melanoma
   Acute HIV Syndrome
   Acute Lymphangitis
   Acute Sun Damage
   Adult T Cell Leukemia
   Adverse Cutaneous Drug Reactions
   Albinism
   Alopecia Areata
   Androgenetic Alopecia
   Aphthous Ulcer
   Atherosclerosis
   Bacillary Angiomatosis
   Bacterial Infections
   Basal Cell Carcinoma
   Basal Cell Nevus Syndrome
   Behcet's Syndrome
   Benign Cutaneous Neoplasms
   Calciphylaxis
   Candidiasis
   Capillary Hemangioma of Infancy
   CVL
   Cat-Scratch Disease
   Chancroid
   Chromomycosis
   Chronic Lupus Panniculitis
   Chronic Venous Insufficiency
   Clark Melanocytic Nevus
   Congenital Nevomelanocytic Nevus
   Crest Syndrome
   Cryoglobulinemia
   Cutaneous Candidiasis
   Cutaneous Larva Migrans
   Cutaneous Lupus Erythematosus
   Cutaneous and Mucocutaneous Leishmaniasis
   Cutaneous Pseudomonas Aeruginosa Infections
   Cutaneous Reactions to Arthropod Bites
   Cutaneous T Cell Lymphoma
   Dermatitis
   Dermatofibroma
   Dermatofibroma
   Dermatoheliosis
   Dermatomyositis
   Dermatophytoses
   Dermatophytosis
   Desmoplastic Melanoma
   Disseminated Coccidioidomycosis
   Disseminated Cryptococcosis
   Disseminated Gonococcal Infection
   Disseminated Intravascular Coagulation
   Donovanosis
   Drug Hypersensitivity Syndrome
   Drug-Induced Acute Urticaria
   Drug-Induced Pigmentation
   Eosinophilic Folliculitis
   Erysipelas and Cellulitis
   Erythema Infectiosum
   Erythrasma
   Erythropoietic Protoporphyria
   Exanthematous Drug Reactions
   Exfoliative Erythroderma Syndrome
   Extramammary Paget's Disease
   Eye Stye
   Fixed Drug Eruption
   Gangrenous Cellulitis
   Genital Candidiasis
   Giant Cell Arteritis
   Glucagonoma Syndrome
   Graft Versus Host Disease
   Hand-Foot-and-Mouth Disease
   Herpes Gestationis
   Herpes Simplex Virus: Genital Infections
   Herpes Simplex Virus Infection
   Herpes Simplex Virus: Infections Associated Systemic Immunocompromise
   Herpes Simplex Virus
   Herpes Zoster
   Hirsutism
   Histoplasmosis
   HIV Associated Lipodystrophy Syndrome
   Human Papillomavirus: Mucosal Infections
   Human Papillomavirus: Squamous Cell Carcinoma In Situ
   Human Papillomavirus
   Hypersensitivity Vasculitis
   Hypertrophic Scars and Keloid
   Ichthyosis
   Impetigo and Ecthyma
   Infectious Exanthems
   Infectious Folliculitis
   Infective Endocarditis
   Infestations of the Skin
   Kaposi's Sarcoma
   Kawasaki's Disease
   Keratoacanthoma


Home :: Acral Lentiginous Melanoma

Acral Lentiginous Melanoma

Acral lentiginous melanoma (ALM) is a special presentation of cutaneous melanoma arising on the sole, palm, fingernail or toenail bed. ALM occurs most often in Asians, sub-Saharan Africans, and African Americans, comprising 50 to 70% of the melanomas of the skin found in these populations. It occurs most often in older males (60 years) and often grows slowly over a period of years. The delay in development of the tumor is the reason these tumors are often discovered only when nodules appear or in case of nail involvement, the nail is shed; therefore, the prognosis is poor. The tumor may be misdiagnosed as a verruca plantaris, subungual hematoma, or an onychomycosis of the fingernail or the nail of the large toe. Subungual melanoma most often occurs on the nail bed of the thumb or large toe. The clinical features are less striking than in other melanomas, appearing in the radial growth phase as macules: dark brown, blue-black, or black, with little variegation and often ill-defined.

Causes of Acral Lentiginous Melanoma

Relatively rare compared to SSM in whites. Probably same incidence in Asians/blacks who have fewer melanomas in general. The pigmented macules that are frequently seen on the soles of African blacks could be comparable with Clark's dysplastic melanocytic nevi.

Symptoms of Acral Lentiginous Melanoma

  • asymmetry of lesion
  • border irregularity
  • bleeding
  • crusting
  • color change or variegation
  • longitudinal tan, black, or brown streak on a finger or toe nail
  • pigmentation of proximal nail fold
  • areas of dark pigmentation on palms of hands or soles of feet

Diagnosis

In the medical literature, melanoma diagnosis is often divided into clinical diagnosis and pathological diagnosis.  Clinical diagnosis includes first recognizing the clinical appearance is abnormal (by either a patient or doctor), recommending appropriate removal of tumor, and possible radiological testing (chest x-rays, CT scan, PET scan) and bloodwork (CBC, LDH,).  Pathological diagnosis comes after the removed lesion is examined in the lab under a microscope.  This exam includes histological criteria results that will enable the treating physician to both stage and decide on future treatments for the patient.  Usually, the clinical and pathological diagnoses are similar, but in cases of thin melanomas that are invasive or ulcerated, the pathological diagnosis will be more reflective of the true situation. 

Treatment

In considering surgical excision, it is important that the extent of the lesion be ascertained by viewing the lesion with a Wood's lamp and epiluminescence microscopy. The borders of the tumor are indistinct or blurred. There may be a spread of pigment around the nail and onto the nail fold. Subungual ALM and volar type ALM: amputation [toe(s), finger(s)] and volar and plantar ALM wide excision with split skin grafting. Sentinel lymph node procedure necessary in most cases.

More Skin Disorders
 
   Langerhans Cell Histiocytosis
   Leg Ulcers
   Lentigo Maligna
   Leprosy
   Leukemia Cutis
   Livedo Reticularis
   Localized Infection
   Lupus Erythematosus
   Lyme Borreliosis
   Lymphogranuloma Venereum
   Lymphomatoid Papulosis
   Malignant Melanoma of the Mucosa
   Mammary Paget's Disease
   Mastocytosis Syndromes
   Measles
   Melasma
   Merkel Cell Carcinoma
   Metastatic Cancer to the Skin
   Molluscum Contagiosum
   Mycetoma
   Mycobacterium Fortuitum Complex Infection
   Mycobacterium Marinum Infection
   Mycobacterium Ulcerans Infection
   Necrobiosis Lipoidica
   Neisseria Gonorrhoeae Infections
   Neurofibromatosis
   Nodular Melanoma
   Nodular Vasculitis
   Nongenital Herpes Simplex Virus Infection
   North American Blastomycosis
   Onychomycosis
   Oral Hairy Leukoplakia
   Oropharyngeal Candidiasis
   Other Viral Infections
   Papulosquamous Conditions
   Pediculosis Capitis
   Pediculosis Pubis
   Pediculosis
   Photoallergic Drug Induced Photosensitivity
   Phototoxic Drug Induced Photosensitivity
   Phytophotodermatitis
   Pitted Keratolysis
   Pityriasis Versicolor
   Polyarteritis Nodosa
   Polymorphous Light Eruption
   Porphyria Cutanea Tarda
   Port-Wine Stain
   Premalignant and Malignant Skin Tumors
   Pressure Ulcers
   Pruritic Urticarial Papules
   Pseudoxanthoma Elasticum
   Pyogenic Granuloma
   Radiation Dermatitis
   Raynaud's Disease
   Reiter's Syndrome
   Rocky Mountain Spotted Fevers
   Rosacea
   Rubella
   Xanthelasma
   Xanthomas
   X-Linked Hyper-IgM Syndrome
   Xeroderma Pigmentosum
   Yaws
   Yellow Fever
   Yellow Nail Syndrome
   Zygomycete
   Zinc Deficiency

Skin Disorders || Contact Us || Tweet

Copyright © Skin-disorders.net All Rights Reserved.

Disclaimer - The data contained in the Skin-disorders.net Web pages is provided for the purpose of educational purposes and information only. It is not intended nor implied to be a substitute for professional medical advice and shall not create a physician - patient relationship. We are not responsible for any consequence resulted from using this information. Please always consult your physician for medical advices and treatment.