How acral melanoma is treated

Care is tailored to melanoma on palms, soles or around nails because removing enough tissue must be balanced with wound closure, hand function, walking and footwear.

After biopsy confirms melanoma, the tissue report helps define the width of further excision. The surgeon removes the biopsy site with a planned border of normal-looking skin. Closure may involve stitches, a skin graft or movement of nearby tissue, depending on the location and resulting defect.

A sentinel lymph node biopsy may be offered to check the first draining node when staging information could change management. If disease has reached lymph nodes or other organs, the multidisciplinary team may consider immunotherapy, targeted treatment when the tumour carries a relevant change, radiotherapy, surgery, or a combination.

Tell the team about medicines that affect bleeding, diabetes, circulation problems, allergies and previous difficulty healing. Do not stop prescribed medicine unless the treating clinician gives instructions. Plan transport and practical help if the wound will limit walking, footwear, gripping or lifting.

Follow the dressing, elevation and movement advice provided for the exact operation. Keep scheduled skin and lymph-node checks after treatment, and report new skin marks or lumps between visits. Follow-up is intended to assess healing, detect recurrence and review the rest of the skin.

Before treatment, alert the team if the lesion begins bleeding heavily, breaks down or becomes painful, or if you find a new lump near the affected limb. These changes need clinical assessment and may affect planning, but they do not establish the stage by themselves.

Following surgery, seek urgent advice for bleeding that does not stop with firm pressure, a cold or pale finger or toe, rapidly increasing swelling, fever, pus, spreading redness, or worsening pain. Contact the oncology team promptly for severe or unusual symptoms during systemic treatment, using its treatment-specific instructions.

Ask what stage has been assigned, how much tissue will be removed, how the wound will close, and what function may be limited during healing. Clarify the purpose and possible consequences of lymph-node testing, whether tumour testing could guide medicine, who coordinates rehabilitation, and what follow-up schedule applies to you.