Acral melanoma on the foot: signs and next steps

It begins in pigment-producing cells on acral skin. A clinician cannot confirm it from appearance alone; diagnosis requires examination of tissue from a carefully planned biopsy.

Acral melanoma may present as a brown, black or mixed-colour patch on the sole, including a spot mistaken for a bruise. Around a toenail, it may appear as a dark band that becomes wider or extends onto adjacent skin. Some lesions lose pigment, thicken, crack, bleed or form a sore.

These appearances have several possible explanations, including injury, infection and benign pigmentation. Persistence or evolution is the reason for assessment, not proof of a particular diagnosis. Foot pressure and repeated friction can also make a lesion look irritated.

Photograph the area in clear light with a size reference, note when you first saw it, and arrange a dermatologist appointment. Avoid trimming, filing or treating it with acid-based corn or wart products before it is examined. Remove toenail polish when a nail is involved.

The dermatologist may inspect the mark with magnification and recommend a biopsy. If melanoma is confirmed, the report and clinical assessment guide removal of the tumour and whether lymph-node assessment or medicine is relevant. Treatment planning also considers wound healing, walking and footwear.

Request prompt review for a mark that is enlarging, changing colour or shape, spreading beyond a toenail, repeatedly bleeding, or failing to heal. A new dark area without a clear injury also merits examination, particularly when it persists.

Contact the treating team urgently after a procedure if the foot becomes increasingly red, hot or swollen, the wound drains pus, fever develops, or pain rises rather than settles. These changes can signal a wound complication and need direct assessment.

Ask how the biopsy site was chosen, what the tissue report says about depth and edges, and whether further surgery or lymph-node assessment is advised. Discuss how much weight you may put on the foot, what dressing and footwear are suitable, who can help with mobility, and what changes should trigger an earlier follow-up.