Moles on the soles of the feet and palms of the hands

Greetings to all lovers of skin health and skin cancer prevention!   I am Dr. Sebastian Podlipnik, a skin cancer specialist working at the Hospital Clínic in Barcelona. In my dermatological career, I have had the opportunity to study and care for a wide variety of cases, and today I want to immerse you in a topic that often goes unnoticed and is the subject of much controversy: moles on the soles of the feet and palms of the hands. 

Have you ever wondered why moles on hands and feet deserve special attention?

Although these small skin "companions" may go unnoticed due to their unusual location, their importance and the care they require are just as crucial as those of any other mole on our body. From their appearance to their possible link to skin cancer, we will explore together the mysteries and concerns surrounding these moles, as well as the steps we can take to keep our skin in optimal health. 

 Keep reading, because I'm going to tell you everything you need to know!

Artistic cover image showing moles on the soles of the feet and palms of the hands of a patient.

What will I talk about in this article?

Why are moles on the soles of the feet different from those on the palms of the hands?

The main reason for moles on the soles of the feet and the palms of the hands is because the skin in this area is different and is called acral skin.. In general terms, the stratum corneum of the epidermis is much thicker and folds giving a fingerprint appearance. This makes moles in these areas acquire different characteristics and in the past it was more difficult to characterize them as benign or malignant. 

As you can see in the following images, I have put a magnified photo of these folds and also how they look under the microscope. The skin in this location is very special and that will make the moles on the soles of the skin and the palms of the hands look totally different as well. 

Acral skin

skin lines on the soles of the feet and the palms of the hands

Microscope

Histological image of the skin of the sole of the foot to illustrate what a mole on the sole of the foot looks like.

In addition, there are other reasons why moles may be different in these locations.

  • Sun exposure: The soles of the feet and the palms of the hands are usually less exposed to the sun and therefore may have fewer changes related to sun exposure.
  • Pressure and friction: The soles of the feet are subject to increased pressure and friction due to daily activity, which can influence the shape and texture of moles in this area. The palms of the hands are also subject to some friction, but to a lesser extent than the feet. It is believed that this is one of the reasons why melanoma appears on the soles of the feet.Quote
  • Genetic differences: Genetics plays an important role in mole formation, and individuals may inherit predispositions to develop certain types of moles on different areas of the body.
Read on and I will show you what moles and melanomas (malignant moles) look like in this location.

Are moles on hands and feet really more dangerous?

Actually, moles on the soles of the feet and the palms of the hands They are NOT more dangerous than moles on the body. This is a concept left over from the older generation of specialists, who did not have adequate diagnostic tools to detect melanoma early and therefore preferred to remove all moles in these locations. 

Fortunately, however, things have changed radically over the last few years and we now have a revolutionary tool: the Dermatoscope!

How do we study moles on hands and feet?

Since we introduced the dermatoscope into our routine clinical practice, we are able to make very accurate diagnoses even in areas that were very difficult to evaluate in the past, such as the acral skin. 

What is a dermatoscope?

Dermatoscopy Sebastian Podlipnik

A dermatoscope is a tool that allows dermatologists to examine moles to detect structures that may indicate skin cancer. The polarized light in the dermatoscope eliminates reflections from the skin surface, allowing a clearer view of skin structures and pigmentation patterns, facilitating the identification of malignant skin lesions.

The scientific study that changed everything

In 2004, this study appeared in the prestigious journal JAMA dermatology. Quotewhere dermoscopic criteria for benign pigmented lesions on the hands and feet were defined. Thanks to these criteria, we are now able to differentiate much more precisely the difference between melanomas and moles in acral locations. 

Illustration from JAMA dermatology showing dermoscopic criteria for moles on the feet.

It is interesting to note that this article was written by my current bosses, and great friends, at the Hospital Clínic de Barcelona, who are recognized as leading experts in the field of dermoscopy worldwide. Personally, I have a deep respect and appreciation for them because of their significant contribution to this field of dermatology.

What do moles and melanoma on the skin of hands and feet look like?

To better illustrate these images I will show you below some images of what this type of mole looks like in this characteristic location. It is also important to have some clues to know if this mole has benign or malignant characteristics. 

What do moles on the soles of the feet and palms of the hands look like?

Moles on the soles of the feet tend to appear during childhood and adolescence. They can also appear later in life, however it is less common. It is important to know that Moles are stable lesions that will not change or grow over time.and that should reassure us.

Here are some pictures of moles on the soles of the feet and palms of the hands.

Clinical imaging

Clinical image showing a mole on the sole of the foot

Dermatoscopic image

Dermatoscopic image of a mole on the sole of the foot

What do melanomas on the soles of the feet and palms of the hands look like?

Melanoma, the most serious type of skin cancer, usually develops in areas of the skin that have been exposed to excessive sunlight, however, It can also do it in places where the sun rarely reaches, like your feet! This type of melanoma is called acral lentiginous melanoma.

The big problem with this skin cancer is that the majority of people with people do not usually check their feet for signs of melanoma, And that's a problem because this cancer sometimes spreads before you know it.

When melanoma develops on the acral skin, it can manifest as a changing mole or spotbut you can also do it in the following ways:

  • A pink or red spot or wart that is growing
  • A new stain on the site of an injury you had some time ago
  • A nonhealing foot ulcer (or an ulcer that heals and comes back) 

Melanoma on the foot can sometimes be painful, bleed or itchy, but this is not always the case. In fact, most of the time it can be totally asymptomatic and only manifest itself as a spot that grows.  

Here are some images with some examples of this type of melanoma:

Clinical imaging

Dermatoscopic image

Clinical imaging

Image of a patient with melanoma on the sole of the foot.
Image obtained from surgicalcosmetic.org.br

Clinical imaging

Image obtained from PCDS

Are there people who are more predisposed to develop acral melanoma?

Melanoma is a rare form of skin cancer, accounting for 2% to 3% of all melanoma cases. However, it is the most common type of malignant melanoma in people who traditionally have dark skin, especially in African-Americans and people of Asian and Middle Eastern origin.

And are polka dots on the nails different?

Another very curious place where moles can also appear on the hands and feet, are the nails. In this case, they are different and look like lines of pigment that grow along the nail. I recently wrote a very complete article about moles and melanoma on the nails that you can review here.

Illustration of a mole on the fingernail
Clinical image showing a black line on the nail of a child. Also known as longitudinal melanonychia or nail mole.

Conclusions

The moles on the soles of the feet and palms of the hands are NOT more dangerous than on the rest of the body.. However, this area is more difficult to evaluate because we do not normally look at the soles of our feet. In addition, there is a diagnostic delay in the case of melanoma, because these are areas that are not normally examined or that doctors do not usually check during consultations. 

In summary, awareness and vigilance are critical in the early identification of melanoma on the feet and hands. Any suspicious skin changes in this area should be evaluated by a dermatologist to ensure timely diagnosis and treatment. 

Sebastian Podlipnik posing in a blue coat. He is an expert dermatologist in skin cancer, aesthetics and laser in Barcelona.

Do you have doubts about this type of moles?

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Sebastian Podlipnik - Skin cancer

Sebastian Podlipnik

Dermatology Blog

I am a dermatologist and cum laude MD and author of multiple research studies. I specialize in skin cancer, laser technologies and cosmetic dermatology. The intention of this blog is to bring you closer to topics of interest in dermatology and research.

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