TAKE-HOME LEARNING POINTS
• Acral lentiginous melanoma is associated with a generally poor prognosis, primarily due to delayed diagnosis.
• This type of melanoma is typically found on the scalp, palms, or soles, under nails, and even in the mouth. The thumb and big toe are the most common locations when hands or feet are involved.
• Patients with darker skin are far less likely to develop melanoma than their fair-skinned counterparts—but when they do, the aforementioned locations are the most common.
• For nondermatology providers, affected patients should probably be referred to dermatology for evaluation and possible biopsy.
• For any subungual or periungual lesion noted on physical examination, a history should be sought.