Skin cancer: Itchy toes as an alarm signal – now Amy wants to warn

It started with a supposedly harmless itching between the toes. American Amy Jardon, 40, scratched but the itch didn’t go away. When she took off the sock, she discovered a tiny stain. “About the size of a pinhead with rings around it,” she recalled in an interview with US broadcaster NBC (Today). “Like a miniature Saturn with rough edges.”

The following week she had a routine appointment with her GP. “I spoke to her about it, but she said, ‘It’s nothing. Don’t worry.’” To be on the safe side, the doctor still performed a biopsy. The surprising diagnosis: akrolentiginose Melanom (ALM).

ALM is the rarest form of black skin cancer in Germany and occurs on hands, feet, fingernails and toenails.

Black skin cancer (malignant melanoma)

According to the German Cancer Society, black skin cancer (malignant melanoma) is the fourth most common form of cancer in women and the fifth most common form of cancer in men.

Most are dark or black spots, but they can also be grayish, bluish-purple, or reddish, and can be flat, raised, or nodular.

The following forms are therefore distinguished:

• Superficial spreading melanoma: The most common type of melanoma at 60 percent. Commonly appear on the back, chest, arms, and legs. As a rule, it spreads out horizontally over a longer period of time before it often grows vertically very quickly.
• Nodular Melanoma: Around a fifth of all melanomas are of the nodular, i.e. nodular, type. They also mainly affect the back, chest, arms and legs. The brown to blue-black, sometimes red nodules are smooth, warty, or ulcerated (ruptured) and bleed easily. They grow much faster than superficially spreading melanomas and usually immediately in depth.
• Lentigo Maligna Melanoma: Grows preferentially on light-exposed areas such as the head and often slowly over several years. They are light to dark brown or white to blue-grey in color, are mostly flat and are typically seen in the elderly.
• Acral Lentiginöses Melanom (ALM): The rarest type of melanoma, at around four percent, affects the “acren”, i.e. the fingers and toes, but also the palms of the hands, soles of the feet and the nail bed. ALM harbors dangers because it is detected less quickly and a diagnosis is therefore often made very late.
• mucosal melanoma: Mucosal melanoma is a very rare subtype that occurs in the mucous membranes and is characterized by a poor prognosis. In addition to the oral and genital mucous membranes, other, more hidden areas such as the paranasal sinuses can also be affected.

The greatest risk factors are:

• Strong, recurring UV exposure with sunburns (especially in children and adolescents),
• tanning salon visits,
• increasing age,
• Cases of black skin cancer in the close family (parents, siblings),
• fair skin type (I and II) and
• many birthmarks or liver spots.

Detect black skin cancer using the ABCD rule

Common to all malignant melanomas are the Irregularities according to the so-called ABCD rule :

• A symmetry: A spot that is not evenly round or oval in shape is conspicuous.
• B Limitation: Moles should be sharply defined and regularly defined. Fuzzy or blurred boundaries, as well as irregular fraying or spurs should be a cause for caution and control.
• C olour (color): Pigmented moles with multiple tints should be observed closely.
• D Diameter: Moles larger than two millimeters in diameter should be closely monitored and checked.

Important: You should visit a dermatologist regularly to have a so-called skin screening carried out. He also makes the diagnosis using the ABCD rule and clarifies potential melanomas with a tissue biopsy.

treatment and chances of recovery

The earlier the malignant melanoma is recognized and treated, the greater the chances of recovery. According to the German Cancer Society, most malignant melanomas (two thirds) are detected so early that they can be surgically removed and the patient is cured.

It is safest to excise all of the melanoma and some of the surrounding skin to remove any tumor cells that have migrated. In addition to surgery, radiotherapy, immunotherapy, chemotherapy or a combination of these therapies can also be considered.

“This is often overlooked”: Amy Jardon wants to create awareness

“I was shocked,” Jardon recalls of the moment of the diagnosis. Her sister had been diagnosed with another type of cancer six months earlier. Her mother also died shortly before from cancer. Shocked, she called her father, who tried to calm the runner down with a joke. “At least it’s not your big toe and you can still walk.”

The melanoma was surgically removed and an inch of skin around each side. She was not allowed to put weight on her foot for a month. “I just sat on the couch,” she recalls of the grumpy time for her. Then she could slowly put weight on her foot again. Just a few months after the operation, she ran her first race. Today she can compete in half marathons again.

The 48-year-old now wants to warn others above all: “I would like to emphasize that a melanoma can occur anywhere,” she says. Not as assumed by many, only in sun-stressed areas. “That’s often overlooked.”