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Acral lentiginous melanoma is a form of skin cancer commonly affecting people with dark skin. It is usually found in areas of the body where there is less hair growth, such as the palms, the soles of the feet, under the fingers and toe nails, and in the mucous membranes. The condition is generally asymptomatic or does not have any symptoms, and is often diagnosed late in a person’s life. Patients with acral lentiginous melanoma frequently observe dark spots on the skin, which look like a bruise.
People with dark skin, especially Africans, Asians and black people from North America, are more predisposed to developing this type of skin cancer. There is equal occurrence in men and women. The disease may affect any age group, however, acral lentiginous melanoma is most often diagnosed during the sixth or seventh decades of life.
The cause of acral lentiginous melanoma is still unknown, although genetics may play an important role in increasing the person’s risk for cancer. A person with a family history of cancer has generally a greater chance of developing any form of cancer. Unlike other forms of skin cancer, however, sun exposure does not seem to play a part in the development acral lentiginous melanoma.
Symptoms of the disease often depend upon the site of the body affected. In the nails, dark-colored streaks not related to trauma, and separation of the nails from the nail beds are usually the first manifestations of the disorder. When it occurs in the palms and soles of the feet, it is first seen as a brownish discoloration that does not seem to go away. Acral lentiginous melanoma may also develop inside the mucous membranes of the nose, mouth, anus, external part of the genitals, and the eyes. Nosebleeds, a feeling of fullness inside the nose, and the presence of a pigmented lump inside the mouth are some symptoms of its presence in the mucous membranes.
A dermatologist is a doctor who specializes in the diagnosis, treatment and management of patients with acral lentiginous melanoma, although the patient may also opt to see an oncologist. Diagnosis is usually made through various ways, such as careful physical examination of moles noting for irregular shaped borders, sudden growth in size and color changes. A tissue biopsy is also performed by taking a skin sample from the affected area to determine the depth of the melanoma. Other diagnostic tools used are X-ray, magnetic resonance imaging (MRI), and computed tomography (CT) scan in order to monitor tumor growth rate and exact location.
Treatment for acral lentiginous melanoma varies depending on how invasive the growth has become. For smaller melanomas under the skin, excision is generally employed without the need for other treatment. If it is a large melanoma, excision is still performed but additional treatments are also given. Finger or toe amputation may also be done in order to prevent spread, or metastasis, to other parts of the body.
We (my family) have lived in Edmonton, Alberta, Canada since 1975. Members of our extended family live and have lived here since~1900.
My wife (Eileen) of Irish and Danish ancestry died (age 65) of ALM in August 2009. The disease manifested as a pencil eraser brown spot between the fourth and fifth toes of her left foot. This was misdiagnosed as a fungus in 2006 and misdiagnosis of the primary and of the progress of the disease continued until June 16 2009. Our medical community failed her completely until 41 days before her death.
Everyone she saw has a post graduate degree of some sort. In her case, all of this was wasted. How could this happen? How can so many allegedly well educated people be so routine-bound and so stupid? There has been no apology. And I guess there won't be one.
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