Skin cancer where the sun doesn’t shine
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| Alana Deutsch, MD, Director, Oncodermatology, Montefiore Einstein Comprehensive Cancer Center |
By Alana Deutsch, MD, Director, Oncodermatology, Montefiore Einstein Comprehensive Cancer Center
Bronx Voice
September 14, 2026
NEW YORK, NY - While sun exposure and fair complexion are leading risk factors for many types of skin cancer, a variant of melanoma skin cancer, called acral melanoma, often shows up where the sun doesn’t shine.
Acral melanoma, which develops on the palms, soles, and beneath the fingernails and toenails, is the most common type of skin cancer diagnosed in Black, Hispanic, and Asian individuals.
Acral melanoma is often diagnosed at a more advanced stage of disease, not because it is inherently more aggressive, but because of the less typical locations it involves and the population it affects who generally has a lower risk of skin cancer. Frequently these spots are not noticed, overlooked, or mistaken for something harmless.
Acral Melanoma Warning Signs
Knowing the warning signs of acral melanoma can make all the difference in early diagnosis and ease of treatment.
Signs to pay attention to include:
1) a new dark spot or streak on the palm, sole, finger, or toe that may be changing in size, shape, or color
2) a dark line running lengthwise through a fingernail or toenail, especially if it widens over time or the pigment spreads to the surrounding skin outside the nailbed
3) a sore on any of these locations that does not heal or otherwise bleeds, itches, or is painful without a clear reason
While other conditions, like bruising from trauma or a fungal infection, may often look similar, it is prudent to be evaluated by a dermatologist if any warning signs are present.
A dermatologist may elect to take a biopsy of the affected skin to assist with diagnosis.
When caught early, acral melanoma is highly treatable and surgery to remove the skin cancer may be sufficient for treatment. However, for more advanced melanomas, additional treatments may be recommended including immunotherapy, which are medications that help the body’s own immune system recognize and fight the cancer cells.
It’s important to identify acral melanoma early to minimize the need for more invasive treatment. Montefiore Einstein Comprehensive Cancer Center in the Bronx is a local leader in the diagnosis and treatment of acral melanoma. The multidisciplinary care provided here is individualized to each patient based on the characteristics of their melanoma.
Specialized Field of Oncodermatolgy
A growing field of dermatologists who specialize in treating cancers affecting the skin, as well as side effects of medications used to treat cancer, are called oncodermatologists.
At Montefiore Einstein, having multiple oncodermatologists means our community has access to experts who understand these patterns, recognize subtle early signs of disease, and work with a multidisciplinary team to guide patients through the most current treatment options. Access to local expertise reduces delays in diagnosis and helps close the gap in skin cancer outcomes for our community.
Aside from people with melanoma, those who might benefit from the care of an oncodermatologist include anyone being treated for all types of cancer who are experiencing skin, hair, or nail-related side effects.
Oncodermatologists work alongside the broader oncology team to ensure patients remain on the best treatment for their cancer whenever possible, while minimizing skin-related side effects and optimizing quality of life.
As the weather cools and the summer sun fades into memory, fall is the perfect season to give your skin a closer look. Check your palms, soles, fingers, and toes, and if you see something that looks unusual, schedule an exam today.
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