Foot bumps on bottom

What Explains the Brown Discoloration on the Soles of a 7-Year-Old Boy?

A 7-year old boy presented with a 1-day history of a bruise-like discoloration of the soles of both feet. The discoloration was first noticed after he had taken a bath; his mother initially thought it was dirt but became concerned when it did not scrub off. The parents were very worried and came to the office expecting that their son would need a full examination and laboratory workup.

At presentation, the child denied any pain, itching, or swelling in his feet. He was able to walk and run normally, and his daily activities had not been affected. He did not remember stepping in anything that could have gotten on his feet, and he did not recall any trauma to his feet. His mother and father insisted that he is never without shoes unless he is inside the house. The family had been camping recently, but the boy had had no other exposures, and no one else in the home had similar findings.

The child did not have any other rash, bleeding, or bruising. He and his parents denied any weight loss, muscle aches, joint swelling, night sweats, cough, fevers, or decrease in appetite or activity in the boy. He reported having occasional headaches with no concerning features, which his mother attributed to not wearing his glasses at school.

Findings of a complete physical examination were normal, including cardiovascular, chest, abdominal, and neurologic evaluation, with the exception of macular brown patches on the plantar surfaces of both feet, sparing the arches. The discolored patches ranged from 0.5 to 1.5 cm in diameter and were nontender and nonblanching, with no change in skin texture and no edema or warmth.

What is causing these brown patches?

A. Henoch-Schönlein purpura
B. Subcutaneous hematoma
C. Plant or chemical exposure
D. Kawasaki disease

(Answer and discussion on next page)

Answer: C, plant or chemical exposure

The discoloration on the boy’s feet was suspected to be an external staining, perhaps related to a plant or chemical exposure. The child’s parents were encouraged to go home and examine the house and yard for anything that could have caused the brown stains on his feet.

The parents called back the next day and reported that 2 days before they noticed the discoloration, their son had visited his grandfather’s house, where he had been shelling black walnuts in the garage and walking around in his socks. They examined the socks he had worn that day, and the pattern of discoloration on the boy’s feet was exactly replicated on the socks.

The black walnut tree, Juglans nigra, is native to the central and eastern areas of the United States. Its wood is prized for use in quality furniture, and its nuts are found in many baked goods and touted as a health food that contains antioxidants and ω-3 fatty acids. The husks of the walnut contain an organic compound called juglone, or 5-hydroxy-1,4-naphthoquinone, with the molecular formula C10H6O3.1 Juglone gives the walnut stain its distinctive color.

Historically, juglone has been used as a dye for hair and skin. It is a semipermanent dye that is similar to henna, and it stains the skin with no involvement of the melanocytes.2 It still is used today in some hair dyes and self-tanners, with the carbonyl group of the juglone molecule interacting with the amidogen radical, NH2, in keratin to form a chromophore that reflects a reddish brown color.3 The color change typically lasts 1 to 4 weeks, depending on the intensity of the exposure.

Our patient had a typical manifestation of black walnut husk exposure. However, there are rare reports of more significant reactions, including a report of a bullous reaction on a woman’s hands after she had shelled more than 30 pounds of walnuts.2 Patch testing confirmed a true allergic dermatitis in the woman. In another report, a baker making walnut cakes experienced severe contact dermatitis over the course of months. After a battery of allergen tests, his only positive result was a wheal-and-flare reaction to a skin prick test for walnut.4 Neri and colleagues reported the case of 2 children with acute irritant dermatitis with lamellar desquamation after having thrown walnut shells at each other.3

Reactions to plant exposures can be difficult to sort out. This case reflects the importance of taking a thorough history, which sometimes is gathered over a period of days and not simply during the few minutes allotted for an office visit. In the absence of any other concerning systemic findings, this case also highlights the appropriateness of reassuring parents while taking a watch-and-see approach rather than immediately ordering a battery of tests that are not indicated. n

Sarah R. Boggs, MD, is an assistant professor in the Department of Pediatrics, Division of General Pediatrics, at the University of Virginia in Charlottesville, Virginia.

As a young, healthy African American, Joshua Paschal didn’t think he could get melanoma. The deadliest form of skin cancer is rare among African-Americans, so he wasn’t worried when a tiny dark spot appeared on the sole of his right foot early last year.

“It was as small as a dot that you would do with a pen,” Paschal, 20, a sophomore at the University of Kentucky, told TODAY.

“I didn’t care too much about it because I thought it was a blood blister. I kept playing football and working out and it would grow in small increments.”

By the time he went home last summer, the black spot — located under his big toe — grew to the size of a dime and became surrounded by smaller “satellite” dots. Paschal also felt it sting when he ran or stood for a while.

Thinking it could be a plantar wart, the football player first consulted a podiatrist. But he was quickly sent to a dermatologist for a biopsy. The diagnosis: melanoma.

The spot on the bottom of Paschal’s foot grew from a dot to a large lesion.Courtesy UK Athletics

Skin cancer on the sole of the foot is more aggressive

It’s not unusual to have moles — or nevi, in medical terminology — anywhere on the body, including the soles of the feet and palms of the hands, said Dr. Vishal Patel, assistant professor of dermatology at the George Washington University School of Medicine & Health Sciences, and director of the Cutaneous Oncology Program at the GW Cancer Center in Washington, D.C.

Though, just because you have a spot underneath your foot doesn’t automatically mean it’s a cause for concern. But skin cancer can lurk there.

Melanoma on the extremities — nails, hands and feet — is the rarest subtype of the skin cancer, accounting for less than 5% of all melanomas, Patel said. But it makes up about a third of all the melanomas that African Americans, Indians, Asians and other people with darker skin develop, which is a ten-fold increase compared to the general population, he noted.

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“Patients say, ‘I have dark skin, I don’t have to worry about melanoma.’ This answer is no, this is exactly the type of melanoma we worry about,” Patel said.

This type of cancer — called acral lentiginous melanoma — tends to be more aggressive than other melanomas. It can also be harder to detect because the skin on the palms and soles is thicker than on other parts of the body, which can change how the moles look both to the eye and when a pathologist is doing a biopsy, Patel said.

Joshua Paschal had to undergo three surgeries following his melanoma diagnosis.Courtesy of UK Athletics

Plus, many people just don’t check underneath their feet for any suspicious spots.

“Patients come to see me , they get completely naked and they leave their socks on. They don’t think we have to look between your toes, on the soles of your feet,” Patel said. “A good dermatologist should be looking everywhere — where the sun don’t shine, basically.”

Sun exposure can still mutate moles on the soles and palms, but that’s not the main driver of acral lentiginous melanoma. It can be genetically driven or develop for other, unknown reasons.

The spots tend appear in the rear and front of the sole — areas where the foot gets the most stress when a person walks or runs, according to a 2016 analysis by Japanese researchers, published in The New England Journal of Medicine.

It’s theoretically possible, but it’s not something most runners have to worry about, Patel said.

Paschal, the University of Kentucky student, underwent three surgeries to remove the cancer from his foot. Doctors used a skin graft from his calf to repair the missing tissue in his sole. A biopsy of the lymph nodes in his groin revealed a trace amount of cancer cells, so Paschal began immunotherapy treatment.

He returned to playing football in November, though he had to learn how to run on his right foot again. It has healed, but parts of it feel numb, Paschal said. He gets skin checks, an ultrasound and a PET scan every three months.

“I feel like is what’s keeping everything together, it’s keeping me positive,” he said.

“Whatever you see on your skin that looks irregular, you should get that checked,” Paschal said, adding that he hopes to raise awareness of skin cancer by sharing his story.

Melanoma survivor shares her story after countless skin cancer surgeries

May 1, 201803:29

What to look for:

Remember the ABCDE’s of melanoma. They apply to spots on the palms and soles, too.

Report any changes to your doctor. Because acral lentiginous melanoma is more aggressive, dermatologists have a lower threshold for wanting to biopsy any suspicious spots, Patel said.

Report a blister or any lesion that’s not healing anywhere on your body.

Melanoma lesions are generally painless, but they can be painful if ulcerated or if they press on a nerve.

Think of you and your dermatologist as a team, Patel advised. Actively scan your body between appointments and take pictures of your moles to keep track of changes and show to your physician. Bring any spots that concern you to your doctor’s attention. Working together can boost the chances of catching melanoma in its earliest stages.

What Is Plantar Fibroma and How Is It Treated?

The goal of treatment is to reduce any pain and discomfort and decrease the size of the nodule. Treatment is based on the severity of the nodule, so your individual treatment plan may vary. A typical plan will include one or more of the following:

Topical treatment

Transdermal verapamil 15 percent gel inhibits the growth of fibrosis tissue in the laboratory. When used correctly, it’s claimed that this gel can remodel the affected tissue within 6 to 12 months. However, the scientific evidence for this claim is very limited. Any pain or discomfort usually subsides within 3 months of use if this medication is helpful to a particular user.

The manufacturer of the drug states that skipping or missing doses can slow the rate of recovery, so be sure to follow your doctor’s directions. After the tissue has been remodeled, recurrence is unlikely.

Corticosteroid injection

A corticosteroid is an anti-inflammatory medication. Injecting a steroid into the nodule can reduce pain and inflammation. If the inflammation lessens, it may become easier to walk, stand, and wear shoes.

Although steroid injections are effective in relieving any inflammatory process, the nodule may continue to grow.

Orthotics

Orthotics may be beneficial if the growth is small and hasn’t changed in size. This nonsurgical treatment involves the use of gel or foam pads and insoles to redistribute body weight and relieve pain associated with a plantar fibroma. Although their usefulness is questionable, there is no risk to trying them.

As a result, wearing shoes and standing may become more comfortable. If over-the-counter insoles aren’t improving your symptoms, talk to your doctor about custom options. However, the usefulness of custom orthotics has also been questioned.

You can purchase orthotics online.

Physical therapy

Physical therapy helps break tissue accumulation in the foot. Your physical therapist will help you develop a routine of strength training and stretching exercises that can help increase blood circulation and stimulate cell growth. Increased circulation can also reduce inflammation and relieve pain caused by a plantar fibroma. There are no published studies that show that physical therapy has a significant beneficial effect in the treatment of plantar fibromas, however.

Surgery

In severe cases, your doctor may suggest surgical removal of the fibroma. This procedure can flatten your foot arch and increase your risk of hammer toe, so this procedure is only used as a last resort. On average, recovery can take one to two months.

Bump on the Bottom of the Foot

The presence of bumps on the bottom of your foot can have many causes, including:

Calluses can form if one area of your skin experiences a lot of friction. This can be caused by your shoes.

If you have diabetes, you should be on the lookout for calluses. You’ll want these to be treated by a doctor.

Calluses can also form on the ball of the foot, due to the misalignment of the metatarsal bone, which is directly behind the toe.

Learn more about calluses.

Dyshidrotic eczema

If the bumps on the bottom of your foot are filled with fluid and are itchy, they may be caused by dyshidrotic eczema. Experts think this condition is caused by allergies. People with dyshidrotic eczema may also experience skin that flakes, cracks, or is painful to the touch.

Learn more about dyshidrotic eczema.

Plantar fibroma

Plantar fibroma is a hereditary condition that causes a nodule to form on the bottom of the foot.

The nodule forms in the middle (beneath the arch) of your foot. It may be painful when pressure is applied.

Learn more about plantar fibroma.

Plantar warts are caused by HPV. If you have cuts or weak spots on the bottom of your foot, the virus can enter your body, causing small warts to form. The warts are usually found at the forefoot or heel, or at the base of the toes.

Plantar warts are generally fleshy, rough, and grainy. They are also relatively small. You may notice black pinpoints in the center of these warts. When you walk or stand, you may experience tenderness or pain. Plantar warts usually go away without treatment. However, there are instances when you may want to see a doctor, for example if:

  • your warts bleed or change in color or appearance
  • you have type 2 diabetes
  • your home remedies aren’t effective
  • your warts cause discomfort that affects your day-to-day life
  • you have a weakened immune system

Learn more about plantar warts.

Haglund’s deformity

Haglund’s deformity occurs when a bump on the back of the heel bone forms underneath the Achilles tendon. The bump can become irritated and painful when it rubs against your shoes.

This condition can be difficult to diagnose because it has similar symptoms to Achilles tendonosis.

Learn more about Haglund’s deformity.

Bursitis

Bursas are natural cushions between your bone and the soft tissue that is present throughout your body. Bursa cushions are lubricated. They relieve the friction that occurs during your day-to-day activities.

The synovial membrane houses the lubrication for the bursa. Bursitis occurs after an injury. The membrane becomes inflamed and swells with extra synovial fluid.

If you have bursitis, you will likely notice swelling on or near your big toe. See a doctor right away if the swelling is accompanied by a fever and redness or skin warmth. This is a sign of an infection.

Learn more about bursitis.

Cysts or benign soft tissue tumors

Cysts are sac-like structures with a capsule. The inside of a cyst is usually filled with a substance that is gaseous, semisolid, or liquid. Cysts can be extremely small, visible only under a microscope, or they may grow in size.

As a cyst grows on the bottom of the foot, it can cause discomfort. Cysts usually have no accompanying symptoms.

Learn more about cysts.

Synovial sarcomas

While cysts are benign, synovial sarcomas are malignant. This means they are harmful and may spread to other parts of the body. Cysts and sarcomas can mimic each other at first, though sarcomas are rare.

A sarcoma may not be noticeable at first. However, as it grows, you may notice a lump and swelling on your foot. You may feel pain and numbness. You may also experience a decreased range of motion. The causes of sarcomas aren’t known but are believed to be hereditary.

Learn more about synovial sarcomas.

A Primer on Plantar Warts

That strange-looking bump on the bottom of your foot could be what’s known as a plantar wart. Plantar warts, caused by a virus, strike the soles of the feet, may occur alone or in bunches, and can be quite painful. If you think you have a plantar wart, make an appointment to see a podiatrist to receive a proper diagnosis and treatment.

Plantar Warts: What Are They?

A plantar wart is a wart caused by a type of human papillomavirus, or HPV, which enters the body through tiny cracks in the skin on the bottom of the feet.

Plantar warts:

  • Are found on the sole of the foot
  • May contain tiny black dots
  • Are flat and firm to the touch
  • Are gray, brown, or yellowish in color (and may even look like a callus, a rough patch of dead skin)
  • May be extremely painful, especially when walking or applying pressure

A plantar wart “can take any shape but often resembles a cauliflower with black speckles throughout the lesion,” says Timothy C. Ford, DPM, director of the podiatric residency program at Jewish Hospital & St. Mary’s HealthCare in Louisville, Ky.

Just one plantar wart may appear on your foot, but they can also pop up in bunches, known as mosaic warts. Most often, they are found on the ball or heel of the foot, but can occur anywhere on the sole of the foot.

Plantar Warts: Risk Factors

While anyone can get a plantar wart, young children and teenagers are particularly prone to them.

Plantar warts are “more common in children than adults as we build immunity with age,” explains Dr. Ford. Public showers and baths, pools, and locker rooms are all common areas where you can come into contact with the virus that causes plantar warts, says Ford.

Other risk factors for plantar warts include:

  • Touching another person’s wart
  • Walking barefoot in dirty areas
  • Walking barefoot in warm and damp areas

Plantar Warts: Diagnosis

Even if you’re pretty sure that you have a plantar wart, it’s best to go to a podiatrist for a diagnosis. In some cases, what you think might be a plantar wart is actually something more serious, like skin cancer. While this isn’t very common, it’s still better to check with a podiatrist to be sure.

If it is a plantar wart, you’ll need a podiatrist to treat the condition anyway — you shouldn’t try to take care of a plantar wart yourself. They are difficult to treat and may frequently come back. Often, plantar warts require surgical removal by a podiatrist.

“There are many ways to treat , from topical to surgical , depending on the symptoms and the length of time the wart has been present,” says Ford.

If you suspect you have a plantar wart, make an appointment to see a podiatrist so that you can get a proper diagnosis and treatment. Also, remember to be careful not to allow anyone else to come into contact with your plantar wart, as they can be contagious.

Signs that could be melanoma on your foot

Melanoma, the most serious skin cancer, develops on skin that gets too much sun. It can also begin in places where the sun rarely shines, such as your foot. Because most people never check their feet for signs of melanoma, this cancer often spreads before it’s noticed.

Allowed to spread, melanoma can turn deadly. By checking your feet, you can find it early when it’s highly treatable. Here’s what you need to know to find melanoma on your feet.

Everyone needs to check their feet for signs of melanoma

People of all races and colors get melanoma on their feet. In fact, about the same number of African Americans and Caucasians develop melanoma on a foot.1 For people of African or Asian ethnicity, the feet and hands are the most common places for melanoma to appear.2

About the same number of African Americans and Caucasians develop melanoma on a foot.

Check every part of your feet for signs of melanoma

By thoroughly checking your feet, you can find melanoma early. The following picture shows you where to look.

Pay close attention to places on your feet that have been injured. Even if the injury was years ago, examine the area carefully.

Research has shown that a foot injury may increase your risk of developing melanoma. Bob Marley, a legendary reggae artist, developed melanoma on his foot. It’s believed that the melanoma began where he had injured his foot while playing soccer. He later died of melanoma.

Look for the signs of melanoma

When this skin cancer develops on a foot, you may see the ABCDEs of melanoma, but it’s also possible for a melanoma to have different features. Aside from looking like a changing mole, a melanoma on the foot can appear as a:

  • Brown or black vertical line under a toenail

  • Pinkish-red spot or growth

  • New spot or growth where you injured your foot

  • Rapidly growing mass on your foot, especially where you once injured your foot

  • Non-healing sore on your foot (or a sore that heals and returns)

  • Sore that looks like a diabetic ulcer

Sometimes, melanoma on the foot feels painful, bleeds, or itches, but not always. The bleeding tends to stop and start.

The following pictures show you what melanoma can look like on the foot.

Melanoma on the bottom of a toe

You can see some of the ABCDEs of melanoma. One half of this spot is unlike the other, it has an uneven border, and the color varies within the spot.

Melanoma on the bottom of a foot

Here, you can also see some of ABCDEs of melanoma, such as one half is unlike the other and it is larger than the eraser on a pencil.

Melanoma on the bottom of an African American man’s foot

You can see some of the ABCDEs of melanoma, such as more than one color, uneven border, and one half is unlike the other.

Melanoma beneath a toenail

On the feet and hands, melanoma can begin as a dark vertical line (or lines as shown here) underneath a nail.

Melanoma on a callused heel

You may see melanoma that is brown, black, reddish pink, or flesh colored, and it can appear in just about any shape.

Melanoma can look like an open sore

If you have a non-healing sore on your foot, see a board-certified dermatologist to find out whether it’s a sore or a skin cancer.

A board-certified dermatologist is the skin cancer expert

If you find a spot, growth, or sore that could be a melanoma on your foot, you want to see a board-certified dermatologist. On the foot, melanoma can be mistaken for a number of things, including a wart, normal pigment beneath a toenail, callus, non-healing wound, or another skin problem.

A board-certified dermatologist has the tools needed to get a closer look at a suspicious spot on your skin. By using a dermoscope or Wood’s lamp, a dermatologist can see patterns that one cannot see with the naked eye.

By seeing a board-certified dermatologist, you can also be reassured that you are seeing the medical doctor who has received the most training and experience in diagnosing skin cancer.

If you find a suspicious spot on your foot, you can locate a dermatologist near you by going to, Find a dermatologist.

Images
Images 1-2: Getty Images

Images 3,4,5,7,8: Used with permission of the Journal of the American Academy of Dermatology:

  • J Am Acad Dermatol.2018;78(1):179-182.e3

  • J Am Acad Dermatol. 2006;55(5):741-60

  • J Am Acad Dermatol. 2017;76(2):S34-6

Image 6: Used with permission of DermNet New Zealand

Lambert Smith J, Wisell J, et al. “Advanced acral melanoma.” JAAD Case Rep. 2015;1(3):166-8.

Madankumar R, Gumaste PV, et al. “Acral melanocytic lesions in the United States: Prevalence, awareness, and dermoscopic patterns in skin-of-color and non-Hispanic white patients.” J Am Acad Dermatol. 2016;74(4):724-30.

Persechino F, Longo C, et al. “Acral melanoma.” J Am Acad Dermatol. 2017;76(2) suppl 1: S34–6.

Shin TM, Etzhorn JR, et al. “Clinical factors associated with subclinical spread of in situ melanoma.” J Am Acad Dermatol. 2017;76(4):707-13.

Sondermann W, Zimmer L, et al. “Initial misdiagnosis of melanoma located on the foot is associated with poorer prognosis.” Medicine (Baltimore). 2016;95(29):e4332.

Learn the ABCDs of melanoma. If you notice a mole, bump, or patch on the skin that meets any of the following criteria, see a podiatrist immediately:

  • Asymmetry – If the lesion is divided in half, the sides don’t match.
  • Borders – Borders look scalloped, uneven, or ragged.
  • Color – There may be more than one color. These colors may have an uneven distribution.
  • Diameter – The lesion is wider than a pencil eraser (greater than 6 mm).

To detect other types of skin cancer, look for spontaneous ulcers and non-healing sores, bumps that crack or bleed, nodules with rolled or “donut-shaped” edges, or scaly areas.

Diagnosis and Treatment

Your podiatrist will investigate the possibility of skin cancer both through a clinical examination and with the use of a skin biopsy. A skin biopsy is a simple procedure in which a small sample of the skin lesion is obtained and sent to a specialized laboratory where a skin pathologist will examine the tissue in greater detail. If a lesion is determined to be cancerous, your podiatrist will recommend the best course of treatment for your condition.

Prevention

Prevention of skin cancer on the feet and ankles is similar to any other body part. Limit sun exposure, and make sure to apply appropriate sunscreen when you are outdoors and your feet and ankles are exposed.

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Skin Disorders Find a Podiatrist

Acral Lentiginous Melanoma (ALM)

What is acral lentiginous melanoma?

Acral lentiginous melanoma (ALM) is a specific type of melanoma that appears on the palms of the hands, the soles of the feet, or under the nails. Melanocytes contain your skin color (known as melanin or pigment). In this type of melanoma, the word “acral” refers to the occurrence of the melanoma on the palms or soles. The word “lentiginous” means that the spot of melanoma is much darker than the surrounding skin. It also has a sharp border between the dark skin and the lighter skin around it. This contrast in color is one of the most noticeable symptoms of this type of melanoma.

Though relatively uncommon in the general population, ALM is the most common type of melanoma in people with darker skin and those of Asian descent. However, it can be seen in all skin types. ALM may be hard to recognize at first when the patch of darkened skin is small and looks like little more than a stain or bruise. ALM sometimes develops from an existing mole. It can also occur seemingly out of nowhere on healthy skin. Early diagnosis and treatment are essential.

Where ALM Can Develop

The most visible symptom of ALM is typically a dark spot of skin that’s surrounded by skin that remains your normal skin color. There’s a clear border between the dark skin and the lighter skin around it. You’ll usually find a spot like this on or around your hands and feet, or in the nail beds.

ALM spots may not always be dark-colored or even dark at all. Some spots may be reddish or orange in color — these are called amelanotic (or non-pigmented).

Warning signs of ALM include:

  • a new streak in a nail that is not caused by an accident or bruise
  • a nail streak that has damaged the fingernail
  • a changing spot in or connected to a mole on the foot or hand
  • an irregularly-shaped growth on the foot or hand that is changing, growing or has an unusual color
  • an elevated, thickened patch growing on the sole of the foot or palm of the hand

Palm or Sole

Most people first notice an oddly shaped black, gray, tan, or brown mark with irregular borders.

Acral lentiginous melanoma affects the feet and hands, as well as the skin beneath the nails. Image credit: Image credit: Will Blake, (2006, May 29)

Under a Nail

The first sign may be a “nail streak,” a narrow, dark stripe under the nail. ALM usually develops on the thumb or big toe; however, it can occur under any fingernail or toenail. Not all nail streaks are melanoma; many dark-skinned people may have nail streaks that are completely benign. Most cases of ALM on the nails occur on the big toe or thumb. As the spot of ALM grows, your nail might begin to crack or break altogether, especially as it advances to later stages.

Subungual (nailbed) melanoma is less common but represents about 33% of melanomas in dark-skinned people. Characteristics include a brown or black linear nail band(s) often wider than 5 mm with a blurred or irregular border with the thumb and big toe being the primary nail site. Approximately half of these tumors may have little or no color leading to a delay in diagnosis. The colored nail band variety can be confused with a fungal infection (especially in the toe) or trauma thus leading to misdiagnosis and/or delay in treatment.

Causes and risk factors

Anyone can develop ALM. Unlike other forms of melanoma, ALM does not appear to be related to sun exposure. In some people, it may be due to a genetic risk factor. People whose family members have developed melanoma, including ALM, may be more prone to the disorder.

Death rates from ALM are higher than those of other forms of melanoma. This may be because ALM goes unnoticed longer, allowing it to progress and become more aggressive before treatment begins. Early diagnosis and prompt treatment have a major impact on whether a person will survive. However, a large number of people who have ALM are initially misdiagnosed with something else.

Researchers do not know why survival and cancer aggression seems to vary across different groups. It could be due to differences in medical care or because some groups are more likely to notice and seek treatment for signs of skin cancer.

Though ALM is rare, it can be deadly. Monitoring the skin for changes can be life-saving. As researchers do not yet know what causes ALM, they also do not know how to prevent it. The best opportunity for a favorable outcome is a prompt diagnosis. It is important to schedule an annual skin examination with your dermatologist. You should promptly see a doctor if an unexplained lesion appears on a hand, foot, or nail. If you begin to see signs of ALM by using the ABCDE rule, see your doctor as soon as possible so that they can take a biopsy of the area and decide whether the spot is cancerous. As with any form of cancer or melanoma, diagnosing it early can help make treatment easier and the effect on your health minimal.

Other Things to Know About Acral Lentiginous Melanoma

As an ALM tumor increases in size, it usually becomes more irregular in shape and color (although some ALM lesions can be lightly colored or colorless).

The surface of the ALM lesion may remain flat, even as the tumor invades deeply into the skin.

Thickening ALM on the sole of the foot can make walking painful and be mistaken for a plantar wart.

The surface of a spot of ALM may also start out smooth and become bumpier or rougher as it evolves. If a tumor begins to grow from the cancerous skin cells, the skin will become more bulbous, discolored, and rough to the touch.

Less advanced cancers and thinner tumors have better survival rates. Raised tumors tend to be more aggressive.

Men are more likely than women to have thick, large tumors at diagnosis. A person’s race is also a factor, with non-Hispanic whites having lower rates of similar tumors at the time of diagnosis.

Corn and Callus

Your doctor may ask you to return regularly to have your feet examined and your corns and calluses shaved, if necessary.

You also can minimize corns and calluses by regularly rubbing them with a pumice stone, which is available in most drug stores.

After the corn or callus is shaved down, application of salicylic acid plasters or pads (available over-the-counter) can be helpful. However, this treatment should not be used by people with nerve disease (neuropathy) or circulation problems in the feet.

In rare cases, foot surgery may be necessary to treat corns and calluses that keep returning and are not relieved by padding, shoe inserts and periodic shaving. Never try to shave or cut a corn or callus on your own. Instead, use a pumice stone to trim it down safely.

When To Call a Professional

Make an appointment to see your family doctor, orthopedic surgeon or podiatrist if you have painful corns or calluses.

If you have diabetes or poor circulation, examine your feet every day. For the best view, use a mirror to inspect the soles of your feet and the skin folds between your toes. If you see an area of redness, swelling, bleeding, blisters or any other problem, call your doctor promptly.

Prognosis

Although corns and calluses tend to return even if they are removed, this may be less likely if you use foot padding and shoe inserts.

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Further information

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