Information about Acral Lentiginous Melanoma
Acral melanoma is a rare type of melanoma that develops on the palms, soles, or around the nails. When it develops in the nail unit, it is called subungual melanoma. These melanomas can affect people of any skin colour and are often overlooked because they occur in places people do not routinely check
People with darker skin tones commonly have longitudinal melanonychia—brown or black streaks running lengthwise along the nail. In many cases, these streaks are completely benign and result from increased melanin production in the nail matrix.
However, subungual melanoma (melanoma arising under the nail) can occur in people of all skin colours but is proportionally more common in people with Black, Asian and Hispanic backgrounds than other melanoma subtypes.
Subungual melanoma … signs that should prompt medical assessment include:
• A new dark streak appearing in a single nail, especially in adulthood.
• A streak that is widening, darkening, or changing in appearance over time.
• A streak that is wider than 3 mm or has irregular borders or multiple shades of colour.
• Pigment extending onto the surrounding skin or cuticle (Hutchinson’s sign).
• Changes to the nail itself, such as splitting, cracking, distortion, or lifting.
• Persistent bleeding, ulceration, or a lump beneath the nail.
• A personal or family history of melanoma.
Check your Hands, Feet and Nails
Know your Skin-Notice Changes-Act Early
Most dark nail streaks in people with Black skin are harmless, but any new, changing, widening, or irregular streak in a single nail should be checked by a dermatologist. Early assessment is particularly important because subungual melanoma is often diagnosed later than other melanoma types.
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