By Gary M. White, MD
An oddly-shaped nevus at the base of a toe.
Nevi of the hands and feet and particularly of the palms and soles are distinct for several reasons. First, the thickened skin and dermatoglyphics can give them unique clinical, dermoscopic, and histologic features. Second, the scar from biopsy or complete removal can potentially be problematic from a functional standpoint. These features sometimes lead to delay in diagnosis and misdiagnosis of pigmented acral lesions.
Both pigmented and flesh-colored lesions occur. They may be macular or papulonodular. They may be round-to-oval, or oddly-shaped.
As usual, any pigmented lesion should be evaluated for melanoma (see abcde and acral melanoma). Any suspicious lesions should be removed entirely and examined histologically.
Benign nevi on the dorsal foot and of the palm.
Benign nevi, both pigmented and non-pigmented, on the toe.
A congenital nevus on the finger.
A blue nevus on the fingertip.
A blood blister. The key clue here is that the lesion had only appeared 3 days prior.
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