Acral lentiginus melanoma

Hi Ritual and a very warm welcome to our corner of the online community.

I don't have any experience with acral lentiginous melanoma on my foot but I know there are a few people in the group who've posted about it. The most recent is Cerys30 so I've 'tagged' her into my reply to you and hope she'll pop on and share her experiences.

Wishing you all the best

Anne

Thank you, Anne

Hello, there. Yes I had ALM two years ago.

My melanoma was also on the sole of my left foot, near the heel. The surgeon told me the wound would heal in about 3 weeks. Nurse told me 6 weeks. It was 3 months before the graft fully healed. I did everything (and more) that I was told to do but it still took ages! I bought a leg raiser so I could keep my foot elevated above my heart when in bed and I also used this when I was sitting down. I used a surgical boot to avoid putting pressure on the wound. I used crutches for about two months and didn’t put my full weight on my heel until the graft had completely resolved (even though I was told it would be ok to do so). I was probably overcautious but I wanted to do everything I could to heal properly. Bought a ‘limbo’ (plastic leg covering) to use when I was showering to keep the wound dry. I had twice weekly dressing changes for about the first 6 weeks then my partner did the changes every few days. I went through lots of different types of dressings which was stressful and time consuming (yet more hospital/GP visits). The wound looked horrible after the surgery but in 3 months was not bad at all. Two years on and it is still a little sensitive but not a bother. Once the graft has healed fully it’s important to moisturise it every day to stop the skin drying and cracking. I use an over the counter moisturiser for cracked heels which works fine.

Did you have a 1cm or 2cm WLE? I joined a trial and was offered a 1cm which was just as well as my feet are size 4. I’ve had no recurrence of the melanoma but cancer cells were found after the SLNB so I  had 12 months of immunotherapy. 

It’s a bit of a long road to recovery, I’m afraid, but you will get there and hopefully you will take less time than I did. If you have any questions about it, do please msg me.

All the best and  for the SLNB results. As most people say, the waiting is hard. 

Thank you so much for your detailed reply. It's good to have a realistic expectation of the time required to heal the foot. I had a 1cm WLE ( my feet are UK size 5.5). The melanoma was situated on the ball of my foot near the three smaller toes and was quite a wide area.I will order a leg raiser and limbo - thanks for the tips. I have an appointment at plastic surgery outpatients next week, 8 days post surgery, to check the wounds.As you say, it is an anxious time waiting for the SLNB results. It's reassuring to hear from someone who's been through this and out the other side. Glad to hear that you have had no recurrence.

Good that you had the 1cm! Let me know what your results are. Hopefully it’ll all be good and you can put this behind you. If not, and you are offered immunotherapy (I had pembrolizumab), I can tell you a bit about my experience of it if that would help. 

Hi,

I also had a split skin graft on the sole of my foot. My experience and timeline were very similar to Cerys30. 

They took the skin from my thigh. This healed without any real issues, except it was extremely itchy before the scab came off! I kept it very well moisturised with dollops of E45 cream. I found that a cool compress on it helped with the itching.

I second the advice to keep the areas moisturised even after they healed. The grafted area on my foot was tender and plus there was a bit of nerve pain (like an electrical shock each time I took a step) for a few more months. I found that stuffing soft foam padding into my sock to cushion that area really helped with walking. I also bought soft slippers for wearing around the house and did daily gentle walks on the treadmill or around the block to get strength back on that foot. All in all, I was back out on long walks in the hills well within a year of the surgery. 

This was 6 years ago. I can now barely tell that any skin was taken from my thigh. The wound on my foot is dark brown in colour and a little concave but I'm not a foot model, so that's fine! I can also say that the tenderness and nerve pain are fully gone. Touchwood no recurrence til now.

I hope your healing goes well. One day at a time! If you have any questions, please feel free to get in touch. 

Thanks so much for sharing your experience. Walking is an important part of my mental health toolkit. I'm looking forward to being able to go for long walks again in time. Glad you have no recurrence.

Just had my Limbo delivered and I was straight into the shower - bliss! Am now trying out my new leg raiser which is much more stable than a wonky pile of pillows. I'm having my skin graft stitches out tomorrow - not looking forward to the process but it'll be good to be one stage closer to healing. Thanks so much for sharing your tips and experience.

Great! Glad to have helped.

i think you might have sent me a friend request (I got an email) but when i go into my friend requests there’s nothing there! Ignore if you didn’t send one but if you did, I’m not ignoring you….

Hi, I just sent another request. Maybe you can see it now?