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Acral lentiginous melanoma

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Acral lentiginous melanoma (ALM) is a type of melanoma that occurs on the palms of the hands or the soles of the feet. The condition can develop in normal-appearing skin or within an existing mole.

Acral lentiginous melanoma
Photography of a large acral lentiginous melanoma: Large asymmetric dark-brown macule, irregular borders, with several different colors.


ALM begins as a flat patch of discolored skin that may enlarge slowly over time.

Clinical course

Although the cancer cells often remain contained at the skins surface (epidermis) initially, ALM can become invasive and spread as the condition advances. Like other flat forms of melanoma, it can be recognized by the ABCDE rule.

Signs and symptoms

Typical signs of acral lentiginous melanoma include the following

  • Longitudinal tan, black, or brown streak on a nail
  • Pigmentation of proximal nail fold
  • Areas of dark pigmentation (palms of hands)
Acral lentiginous melanoma (ALM)

Although ALM affects men and women of all skin colors equally, is it most commonly diagnosed in people over age 40. The underlying cause of ALM is poorly understood. It is not related to sun exposure like other forms of skin cancer.


Even though the ideal method of diagnosis of melanoma should be complete excisional biopsy


Initial treatment generally consists of surgery to remove the skin lesion. Additional therapy (such as radiation therapy or immunotherapy) may then be recommended depending on the severity of the condition.

The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition.

  • Aldesleukin (Brand name: Proleukin)

Latest research - Acral lentiginous melanoma

Clinical trials

NIH genetic and rare disease info

Acral lentiginous melanoma is a rare disease.


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