ALM (acral lentiginous melanoma) scare

I vowed I would do this post whatever way my results went as when I was looking up around the time of my 2WW referral all I could find were cases that ALM was found. I know this is a forum for those with cancer, but I know plenty of people like me come it across it while doing the worst thing possible - googling symptoms! 

Back at the end of May I was referred under 2WW by dermatology for a freckle on my palm. I’d had it come up in September 2022 and not thought much of it as I have a fair amount of freckles everywhere. However this year it came up in conversation and realised that’s maybe a pretty weird place to have a freckle. Then came the googling and then came the ALM results. I knew it had grown, and looking at photos I could tell it has also gotten darker even within the last year. 

My GP sent a dermascope image to the hospital dermatology team and they decided to refer me under 2WW due to the location. I saw a dermatologist in mid June who was frankly not clear either way and left it to me to decide whether to watch and wait, or have it removed. I opted for removal for peace of mind.  

Due to various issues and NHS wait times, I finally had it removed in mid/late August, and received my results after chasing this week. 

Thankfully these returned as benign:

The lesion excised from your left palm has been reported as benign junctional naevus of special site.

No dysplasia, no melanoma in situ and no invasive melanoma noted.

This post isn’t to say don’t take freckles and moles seriously, as definitely always go to the doctor if you’re concerned / they have any of the characteristics of skin cancer. But just to reassure that ALM is rare, and it turns out that freckles on on your palms and soles are more common than you’d think, so despite what your Google search might be showing you, not all acral freckles are cancerous. 

If you happen to be looking at this waiting for an appointment or results, I wish you all the best and hope your results are also benign. If you’re looking while waiting to get it punch biopsied, having a numb finger from local anaesthetic is weird, and it is an annoying place to have a procedure, it’s not bad at all and it’ll be feeling better before you know it.