Neurologic and Vascular Diseases as Risks for Acral Melanoma in Veterans

Acral lentiginous melanoma (ALM) is a rare kind of skin cancer that appears on the palms of the hands, soles of the feet, or under the nails, areas that may not be examined closely and can present with early signs that are hard to notice. As a result, ALM is often diagnosed at a later stage, when the cancer is thicker or has spread to nearby lymph nodes. This delay in diagnosis makes treatment more challenging and leads to worse outcomes compared to other types of melanoma. Past studies have suggested that ALM may be related to areas of repeated injury or slow wound healing. Many Veterans suffer from long-term nerve damage, known as peripheral neuropathy, or poor blood flow, called peripheral arterial disease (PAD).

These issues can lead to numbness, foot ulcers, and wounds that heal slowly, making the hands and feet more prone to ongoing injuries and poor healing that could lead to this melanoma. Despite this, researchers have not examined if peripheral neuropathy and PAD are directly related to the risk of developing ALM. To understand if they are, this study will look at data from 383 Veterans who have confirmed foot ALM and 383 similar Veterans who do not have it to examine if nerve damage or circulation issues raise the risk of developing ALM. We expect that Veterans with peripheral neuropathy and/or PAD will be more likely to develop foot ALM compared to those without these conditions. We will also investigate how these risks differ by age, sex, race, and ethnicity to identify groups that are at higher risk. By improving our understanding of whether nerve and blood vessel issues contribute to ALM, this research could help improve its screening and prevention efforts as well as possible therapeutic opportunities.