Where the sun don’t shine

The site of a melanoma can affect the appearance

While malignant tissue defies natural laws and grows chaotically there are some sites where that chaotic growth is restrained in the early growth of a tumour by architectural obstacles.

Young melanomas on the face and scalp are restrained by the obstacles of dense hair follicles and are frequently symmetrical, the only clues in such cases being dermatoscopic grey colour and pigmented circles.

An analogous situation occurs on the palms and soles (acral skin) where densely concentrated eccrine (sweat) ducts restrain the peripheral growth of melanomas so that they may be