Patient Education

Malignant Melanoma of the Foot

Description

Every year, when summer finally comes around again, we humans tend to get in the habit of shucking off our clothing. It’s understandable; solar radiation starts cooking up the atmosphere, and our sun-starved winter skin seems to be screaming for a little light. And really, is there anything more pleasant than lying on a blanket outside while the sun banishes thoughts of record snowfalls and subzero temperatures?

Unfortunately, all this lazing about in the sun can do more harm than good, particularly when you go out unprepared to counter the effects of sunlight’s evil side: UV rays. Ultraviolet radiation tends to mess cells up, and, if you’re exposed to a lot of it (from the sun or from tanning beds) it can result in malignant melanoma, a skin cancer that starts out in the cells that produce your skin pigment (skin color). Malignant cancers tend to spread rapidly to other parts of the body, and can result in death if not treated early.

A malignant melanoma can develop anywhere on the skin. When it occurs on the ankle region, foot or toes, it can be mistaken for a bruise that simply won’t heal, or you may simply not think to check the skin of your foot for warning signs. Unfortunately, this means that the melanoma can go untreated for some time, and will be more likely to be fatal by the time it’s finally caught and treated. Melanomas can also show up under toenails.

Anyone can develop malignant melanomas, but you’re more likely to be susceptible if you have light-colored skin, hair that’s blond or reddish, skin that freckles easily, or if you have lots of moles on your body or have had a bad sunburn while you were young.

Symptoms

When your skin begins to give way to assaults from UV rays, you may notice an area of pigmentation in your skin that does some unusual things. It might be flat (level with the surface of your skin), or raised above the surface, and although melanomas are often dark in color, they may also be red, pink, light brown or even white or colorless. It’s good to keep in mind the acronym ABCD when examining your skin for possible melanomas.

  • A: Asymmetry – The mole or spot is not symmetrical. In other words, if you were to draw its shape on a piece of paper, you wouldn’t be able to make two sides match up exactly.
  • B: Border – The mole or spot has an irregular border. The border might look blurry, uneven, jagged, or may have notches in it.
  • C: Color – The mole or spot is not one solid color. Melanomas typically have several colors, usually black, brown, and tan, although they may also include white, pink, blue, or red patches.
  • D: Diameter – The mole or spot grows larger in diameter. Melanomas usually grow larger over time. If you notice a mole or spot that is larger than about 5mm across, or about the size of a pencil eraser, or if you have one that’s getting larger, you’ll want to get it checked out.

Other symptoms of melanomas include their propensity to bleed, itch, or be painful or tender. You may also notice a mole that has spread pigmentation out through the surrounding skin, or you may have a bruise that simply doesn’t seem to heal. You could also find a dark patch or streak under your nail that doesn’t go away, and doesn’t seem to be related to an injury like stubbing your toe or dropping a hammer on your foot.

Diagnosis

Whenever you notice any of the above signs or symptoms on your feet (or anywhere else on your body, really), you should see a medical care provider right away. Your podiatrist (or other doctor) will ask you about the spot, such as how long you’ve had it, whether it’s changed in size, shape or color, and how quickly it has undergone these changes. The best way to tell if a spot is a malignant melanoma is to perform a biopsy (or remove a portion of or the entire spot) and send the tissue to a lab for analysis.

Treatment

Treating malignant melanomas, as in many cancers, often involves surgery to remove the cancer, and chemotherapy or irradiation if necessary. Your doctor can discuss a full treatment plan with you.

Please keep in mind, though, that early detection of malignant melanomas is critical. When this cancer is treated in its early stages, survival rate is about 95%. However, the longer the melanoma goes untreated, the higher the fatality rate gets. Again, it’s always best to see your doctor right away when you notice an unusual mole or spot on your skin or under your toenail.

You can try to keep malignant melanomas from developing in your skin by doing the following:

  • Keep the skin of your feet covered when you go outside. Sandals and flip-flops are hardly your best defense against wicked UV rays. When you plan on going into the water, wear water shoes. Otherwise, keep on regular socks and shoes when you plan on spending a lot of time outdoors.
  • Avoid being out in the sun when the sun’s rays are most direct (usually about 10am to 4pm), and take special care of children and adolescents, who are more susceptible to harmful radiation.
  • Sunscreen is a great way to block harmful UV rays. Be sure to apply it to your feet if they’ll be exposed, and don’t forget to slather the soles of your feet as well as the tops.
  • Be sure to check your feet (and other skin) regularly for signs of discoloration or atypical moles. If you’re into colorful nail polish, take it off once in a while to check for streaks or patches of color beneath your nails.
  • Also, even though feet are the main topic of discussion here, it really will help if you also wear UV-blocking sunglasses, as well as wide-brimmed hats to protect your eyes and neck.

There’s no real reason why you can’t love the sun. Just be aware that the sun doesn’t always love too well in return. Protect yourself from its more malicious attentions, and keep checking your ever-precious skin.