Which melanoma subtype is most commonly seen in darker-skinned individuals and tends to appear on the palms, soles, or nail beds?

• A. Superficial spreading
• B. Lentigo maligna
• C. Acral lentiginous
• D. Nodular

Answer: (C)

Acral lentiginous melanoma is the form that fits this pattern. It more commonly affects darker-skinned individuals and tends to arise on non–sun-exposed acral surfaces—palms, soles, and under the nails. This distribution is distinct from other melanoma subtypes, which are more strongly linked to sun exposure and different body sites. For example, the most common subtype overall in many populations is superficial spreading, often appearing on sun-exposed skin like the trunk or limbs; lentigo maligna tends to occur on sun-damaged facial skin in older adults; nodular melanoma can arise on various sites and presents as a rapidly growing nodule rather than a site-specific pattern.

Clinically, acral lentiginous melanoma may start as a pigmented patch or band on the palm or sole, or a pigmented longitudinal band under the nail, and it can be overlooked because these sites are less routinely examined for melanoma and the lesion may be amelanotic or appear similar to benign conditions. This combination of demographic association and acral site involvement is what makes it the best answer.