Melanoma - dark smudge on foot sole was acral lentiginous melanoma

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Just for info: if you notice a dark smudge/spot on the sole of your foot, do get it checked out.  I had been aware of it since July 2013 - it looked it bit like when you have walked in some tar on the beach and can't wash it off. It didn't look like a malicious mole at all, so it never occurred to me to get it checked out.  I happen to be in a dermatology clinic in the Churchill Hospital in Oxford for something else and they thought it looked suspicious.  I had an ellipse biopsy on 19 May 2015 (it's on the ball of my left foot - a most awkward place, leaving me quite incapacitated). My husband managed to get me crutches from AgeUK, I couldn't have done without them.  Two weeks later the histology report confirmed it was acral lentiginous melanoma, fortunately still 'in situ', so stage T0, I count myself very lucky, had feared much worse since I'd had it for two years.  I had it excised  there and then on the same day 2 June 2015, leaving a wound 3mm deep the size of a 10p piece.  There were no stitches, it had to heal by itself (secondary intention healing).  I suffered a very frightening bleed the night after the op when I went to the loo at 5am - I noticed a pool of blood on the carpet below my foot!  Eek! The district nurse came and redressed the wound.  Convalescence took a long time - I was on the sofa with foot elevated above heart level for what seemed endless weeks.  The histology report of the excised tissue indicated there were still atypical cells in the margins, so further surgery was required by the plastic/reconstructive surgeons team at Oxford: another 5mm margin all round and a skin graft from my groin area, which was done 8 weeks after the first excision, just as the wound was nearly healed.  This was done on 22 July 2015 - five days ago.  This time I have slept on my back on our sofa (which has an electric foot rest) - I didn't want to risk another bleed, no danger of knocking my bandage on the bed clothes as you turn over in bed so that hopefully the skin graft didn't move or come loose.  My foot wound has been very painful as after the first operation, especially in the first few days - paracetemol didn't quite touch it, but it is getting much better now.  It hurst especially when my foot hangs down, so I am keeping it elevated all the time, even trying to keep it horizontal as I go to the loo, rolling along on an old typist chair, just picture the scene!  Can't have a bath because of groin wound (hardly any discomfort at all - beautifully sewn up by the plastic surgeon) nor a shower because I mustn't get my foot wet.  Going back in two days' time to have my very thick bandage removed to see if the skin graft has taken, so keeping my fingers crossed.  Then a week or so later will have another appointment with the plastic surgeon for histology results. They say walking functionality should return to normal, but the graft area will be slightly lower than the surrounding area of the foot (as some fat has been removed).  So I count myself very lucky indeed it just happened to be found accidentally in time.

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  • Posted

    It's two weeks after my Plastic Surgery Op: which further excision of the melanoma with full thickness skin graft and my wound doesn't look very pretty at all.  Very dark areas are starting to appear round the edges,see photo.  I hope it is just the dying off of some of the upper cells of the donor tissue and doesn't mean the graft is beginning to fail?  The district nurse who changed the dressing today didn't seem worried, but then they are not specialist plastic surgery nurses.  I am still keeping my foot elevated most of the time with occasional trips to the kitchen for 10-15mins to make a cup of tea, or a very quick salad.
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  • Posted

    Hi Maja

    Very good post. I stubbled across your post after becoming concerned about a black spot similar to what you had.

    I have had it for maybe five years and have never had it checked. I only started research it today cause if feels a little sore walking. After reading I will go to see my GP immediately. 

    I just hope that it’s nothing serious. It hasn’t changed in size and don’t have any other health problems so just staying positive.

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  • Posted

    Hi

    My husband has a mark very similar to yours and it was because of your picture we became concerned. 

    He visited the gp who wasn’t concerned but I asked for him to be referred to dermatology on the 2 week pathway which he did. We have just seen dermatologist today who said he wasn’t sure what it was as it doesn’t look like melanoma but has offered to remove it in 2 weeks time.

    Did your dermatologist think it looked like cancer straight away or not? I’m surprised he didn’t think it looked like melanoma when it is very much like yours. 

    Anyway hopefully the biopsy will bring us good news and thank you for your picture 

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