Acral nevus (benign nevus of the palms and soles, pigmented nevus of the palms and soles) is a benign skin neoplasm, characterized by its location on the palms and soles. Typically, acral nevus is acquired, but can also be from birth. This type of nevus is not characterized by multiplicity (several acral nevi in one person is rare). Acral nevi make up about 5% of all pigmented nevi.
Predisposing factors
There is no unequivocal cause of acral nevi. It is only appropriate to talk about predisposing factors that may increase the risk of neoplasms to varying degrees:
- Genetic factor: the appearance of acral nevi may be due to the human genome;
- Ultraviolet radiation: artificial or sunlight leads to a faster multiplication of non-void cells (nevus cells) and an excessive production of melanin (pigment, which accumulates in the nevus);
- Hormonal changes: Hormonal fluctuations in the body (especially sex hormones, thyroid hormones and adrenal hormones) can affect the appearance of new nevi and the growth of existing ones;
- Ionizing radiation, viral diseases and injuries can also provoke the appearance or growth of acral nevi.
Diagnosis
The diagnosis of acral nevi is based on clinical examination, which includes a routine examination of the mass and dermatoscopy. A biopsy may be performed if malignant growth is suspected.
Symptoms
Acral nevi are located on the skin of the palms and soles.
Visual examination of an acral nevus reveals a pigmented neoplasm, most often symmetrical (oval or rounded). The outline is usually irregular due to the presence of a pronounced skin pattern on the palms and soles. The nevus surface does not differ from the texture of normal skin or is slightly fine-browned.
The coloring of acral nevus varies from yellowish brown to dark brown (almost black), with a uniform distribution of pigment throughout the mass. Sometimes there is a gradual decrease in color intensity from the center to the periphery.
The size of acral nevi usually does not exceed 10 mm, most often 3-5 mm. When palpating a simple nevus, there are no peculiarities: the consistency of normal skin. Subjective sensations are also absent.
Dermatoscopic description
On dermatoscopy, an acral nevus is visualized:
- Parallel structure – the linearity of the pattern due to the peculiarities of the skin pattern of the palms and feet;
- Pigment accumulation in the furrows of the skin;
- Lighter pigmentation of the scallops of the skin (pale compared to the furrows);
- The scallops are wider than the grooves;
- Visualization at apex of scallops of sequence from mouths of ducts of perspiratory glands (whitish dots);
- Regular pattern of the above elements (regular sequence of grooves, scallops, mouths).
Differential diagnosis
- Differential diagnosis is made with such pigmented neoplasms as:
- Subcorneal hematoma;
- Contamination of the skin;
- Dysplastic nevus;
- Melanoma.
Risks
An acral nevus is safe and carries no increased risk of melanoma. In the absence of external influence on such a nevus (trauma, ultraviolet light, ionizing radiation), the risk of malignant transformation is comparable to the risk of melanoma in unchanged skin. Signs of possible malignancy: change in appearance, appearance of subjective sensations.
At the same time, the characteristic appearance (heterogeneity of pigmentation, cross-linked appearance, irregular edge) of acral nevus can be very similar to that of melanoma, in particular, acral lentigial melanoma. This is why acral nevi that are
detected for the first time should be of particular concern, in order not to miss an early form of melanoma.
Tactics
In the absence of any damaging effects on the acral nevus, changes in appearance and subjective sensations – self-monitoring (or examination by others in inaccessible areas) at least once a year is sufficient. If there was mechanical damage to the nevus, its active exposure to ultraviolet or ionizing radiation, as well as if you notice any changes in the nevus itself or appeared missing sensations – you need to consult a dermatologist or oncologist.
A specialist determines the possibility of further dynamic monitoring (timing is determined individually), or indications are given for removal of the damaged nevus. Nevi should also be removed if they are permanently and chronically traumatized by clothing, jewelry, or occupation.
In the case of dynamic observation, photofixation of the neoplasm of the skin is of great value, which will make it possible to determine even minor changes in the appearance of the nevus in the future.
It is also recommended to make a map of skin neoplasms, which greatly simplifies further observation, search for new formations or change of existing ones.
Treatment
Only surgical (classical, electro- or radioscalpel) with obligatory histological examination.
Treatment of acral pigmented nevi using destructive methods (laser removal or cryosurgery) is not recommended.
Prevention
The prevention of nevi and their malignization is to treat the skin sparingly and gently:
- Limit UV exposure (tanning beds, sun tanning);
- The use of protective creams during periods of active sunshine;
- Exclusion of chronic traumatization of the skin;
- Restriction or exclusion of ionizing radiation, occupational hazards;
- Observe safety precautions when working with skin damaging factors;
- Personal hygiene and basic awareness of skin neoplasms.
Regular examination of acral nevi, timely consultation with a specialist when external changes occur, and removal of potentially dangerous neoplasms are also necessary.
🇬🇧 Acral Nevus: When to Seek Medical Advice in the UK
An acral nevus is a type of mole that appears on the palms, soles, or under the nails (acral areas). Most acral nevi are benign, but because melanoma can also develop in these locations, any new or changing lesion should be assessed promptly.
If you notice a new pigmented spot on the hands, feet, or nails, or changes in an existing lesion, you should contact your GP (General Practitioner) as soon as possible.
Your GP will examine the lesion and may refer you to a dermatologist or specialist skin clinic through the National Health Service for dermoscopic assessment or further investigation if needed.
Early evaluation is important, especially because skin cancers in acral areas can be harder to recognize. Do not delay seeking medical advice if you notice:
- rapid changes in size, shape, or colour
- irregular or blurred borders
- multiple colours (brown, black, grey, or uneven pigmentation)
- a growing dark streak under a nail, especially if it extends onto the surrounding skin
- bleeding, ulceration, or persistent tenderness
- a lesion that looks different from other moles on your body
Most acral nevi are harmless and only require monitoring, but suspicious changes may require closer follow-up or biopsy to rule out melanoma. Early assessment significantly improves outcomes if treatment is needed.
Faster access to specialist care
If NHS waiting times are long, you may consider:
- Seeing a private dermatologist in the UK for quicker assessment
- Using an online dermatology consultation service
- Performing an AI-based mole or lesion check
Find a dermatologist in major UK cities
- Dermatologist in London
- Dermatologist in Manchester
- Dermatologist in Liverpool
- Dermatologist in Birmingham
- Dermatologist in Leeds
Check your skin risk instantly
You can also use the Skinive AI – Skin Scanner. The app allows photo-based assessment of moles and benign growths, helping detect warning signs early and guide whether professional consultation is needed.
🇦🇺 Acral Nevus: When to Seek Medical Advice in Australia
Australia has a high prevalence of skin conditions, so early assessment of unusual or changing lesions is strongly recommended. An acral nevus is a type of mole that appears on the palms, soles, or under the nails. Most acral nevi are benign, but because melanoma can also develop in these areas, any new or changing lesion should be assessed promptly.
If you notice a new pigmented spot on your hands, feet, or nails, or changes in an existing lesion, you should contact your GP (General Practitioner) as soon as possible.
Your GP will examine the lesion and may refer you to a dermatologist or specialist skin clinic for dermoscopic assessment or further investigation if needed.
Early evaluation is especially important because skin cancers in acral areas can be harder to recognize. Seek medical advice without delay if you notice:
- Rapid changes in size, shape, or colour
- Irregular or blurred borders
- Multiple colours (brown, black, grey, or uneven pigmentation)
- A growing dark streak under a nail, especially if it extends onto the surrounding skin
- Bleeding, ulceration, or persistent tenderness
- A lesion that looks different from other moles on your body
Most acral nevi are harmless and only require monitoring, but suspicious changes may require closer follow-up or biopsy to rule out melanoma. Early assessment significantly improves outcomes if treatment is needed.
Faster access to specialist care
If public dermatology waiting times are long, patients often choose:
- Visiting a private dermatologist
- Attending a skin clinic for faster assessment
- Using an online skin consultation service
- Performing an immediate AI-based skin assessment
Find dermatology services in major Australian cities
You can explore dermatology options in:
- Dermatologist in Sydney
- Dermatologist in Melbourne
- Dermatologist in Brisbane
- Dermatologist in Perth
- Dermatologist in Adelaide
Check your skin lesion risk instantly
You can also use the Skinive AI Mole Checker app for skin analysis to evaluate a benign-appearing lesion from a photo and determine whether medical consultation is recommended.
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