What should you know about melanoma dark skin?

Melanin can make subtle colour differences harder to notice, and melanoma is not limited to areas that receive strong sunlight. Check the palms, soles, between the toes, under the nails, the mouth and the genital skin as well as the face, trunk and limbs. A new or changing streak under a nail, a mark that becomes uneven, or a spot that does not match nearby skin deserves attention.

Melanoma can be brown, black, grey, red, pink, purple or less pigmented. It may itch, crust or bleed, but it can also cause no sensation. These signs have other possible explanations, so they should lead to an examination rather than a self-diagnosis.

Use a mirror or ask someone you trust to help inspect hard-to-see areas. Photograph a mark only as a record; a picture cannot replace an examination. Arrange dermatology review for a lesion that changes in size, shape or colour, for a new nail streak that does not grow out, or for a sore that repeatedly breaks down.

A clinician may examine the area with dermoscopy and recommend excisional surgery or another biopsy when melanoma is suspected. If confirmed, pathology determines whether further skin surgery, lymph-node assessment, imaging or immunotherapy is appropriate.

Book prompt care for a changing mark on a palm, sole or nail, a lesion with bleeding or persistent crust, or a spot that is clearly different from others. Seek urgent help for heavy bleeding, rapidly spreading redness with fever, or new weakness, confusion or severe headache in someone already diagnosed with melanoma.

Ask whether the mark needs dermoscopy or removal, how the colour and location affect the examination, whether a nail or sole lesion needs specialist review, and how often your skin should be checked.