Is it a Bruise or Maybe Acral Lentiginous Melanoma?

Let’s talk about something important – Acral Lentiginous Melanoma, or ALM for short. Before we go any further, it’s crucial to understand that there are many different types of melanoma. Unlike most other types of melanoma, ALM is not caused by overexposure to the sun. Instead, ALM is more likely to appear in areas of the body that aren’t often exposed to the sun, such as the soles of your feet! Interestingly, it’s also the most common type of melanoma in people with skin of colour.

Now, let’s explore how ALM develops. It starts when malignant (cancerous) melanocyte cells are found along the deepest part of the top layer of the skin, called the epidermis. When these malignant cells are only found in the outermost layer of the skin, it’s called “ALM in situ,” and it’s not very dangerous. But if the melanoma grows down into the deeper layers of the skin, known as the dermis, it can become potentially life-threatening.

But here’s the good news: just like with other kinds of skin cancer, when we find ALM early, we can treat it, and people usually have better health outcomes. Now, you are probably wondering how to spot ALM? Well, that’s where knowing the warning signs and distinguishing ALM from other benign skin conditions is important.

What does ALM look like?

Unlike other types of melanoma, ALM develops on less sun-exposed areas, such as the soles of the feet and under your nails.

ALM often begins as a black or brown discolouration on the sole of the foot or palm of the hand.

Here are some signs that it might be ALM:

• It may resemble a bruise or a stain.
• It doesn’t go away or heal like a regular bruise.
• Over time, it can grow in size

What is ALM often mistaken for?

A bruise

A stain in the skin

ALM might look a lot like a bruise, which can be confusing! Lesions and dark spots can be challenging to identify and might go unnoticed for a long time, which makes it hard to spot.. But here’s the thing: while a bruise goes away on its own after a while, ALM won’t. So, if you see something that looks like a bruise and it’s not getting better, that’s a sign to pay attention to.

Now here’s the tricky part about ALM – it often appears on unusual parts of the body where you don’t expect, like the soles of your feet. So, it’s important to examine your whole body every month, even in places where you might not think skin cancer could develop. It’s all about staying safe and keeping an eye on changes.

Use CUBED for the Identification of ALM

The CUBED acronym, described below, can help you identify ALM.

Screening is crucial for the early detection of ALM. Here’s how you can make sure you spot ALM:

• Perform monthly self-exams and yearly exams by a physician to help facilitate early detection.
• Remember to check areas of low or non-sun exposure, like your feet, between the toes, palms, and your torso. Missing these spots could result is a delayed diagnosis.
• Follow the CUBED rule for ALM identification and the ABCDE rule for other types of melanoma.
• If you spot something new or if a bruise or spot doesn’t go away or gets bigger, take pictures of it and show them to your physician.

It’s important to remember that skin cancer can look different for everyone, and not all ALM has the same appearance. So, if you see something new, changing, or unusual on your skin, it’s essential to see your primary health care provider, either your family doctor or dermatologist, as soon as possible.

For assistance finding a dermatologist in Canada, visit our website here. Plus, Melanoma Canada’s Mole Mobile, Canada’s first mobile skin cancer screening unit, is currently travelling across Canada to provide lifesaving, free skin cancer screening. You can learn more and sign up to receive email alerts when it is near you at molemobile.ca.

Skin Cancer Prevention:

While there isn’t a known connection between ALM and sun exposure, it is still important to take steps to protect your skin. Melanoma Canada encourages everyone to use sunscreen because it helps prevent sunburns, slows down skin aging caused by the sun, and lowers the risks of developing other types of melanoma or skin cancer.

Early detection is imperative in diagnosing and treating skin cancer. However, prevention is just as important. Here are some things you should think about:

• Regular Skin Examination: Perform regular self-examinations of your skin at home to identify any new or changing moles, lesions, or suspicious spots. Follow along with our skin exam guided video to perform your monthly skin exams and don’t forget areas that are not exposed to the sun.
• Full-Body Skin Examinations by a Dermatologist: Schedule routine skin checks with a dermatologist, who can conduct a thorough examination and address any concerns. Find a dermatologist here.
• Risk Factors: Understand the risk factors for melanoma to better understand if you, or a loved one, are at higher risk.
• Sun Protection: Protect your skin from harmful UV radiation by:

• Applying broad-spectrum, water-resistant sunscreen with an SPF 30 or greater
• Reapplying sunscreen every 2 hours or after sweating or getting out of water
• Seeking shade whenever possible
• Wearing protective clothing (including wide-brimmed hats and UV-protective sunglasses)
• Avoid sun exposure during high intensity hours between 11 am and 3 pm.

• Avoiding Tanning Beds: Minimize or eliminate the use of tanning beds, as they emit very high levels of harmful UV radiation and increase the risk of developing melanoma greatly.

While skin cancer is more commonly seen in places that are frequently exposed to the sun and ultraviolet (UV) radiation, it is important to remember that it can show up anywhere on your body. It’s also important to remember that anyone, regardless of skin colour, can be diagnosed with melanoma. It’s all about staying safe and taking care of your skin!

For more information on ALM, watch our Melanoma Doesn’t Discriminate video