ALM is most frequently seen on the foot of a person with darker skin but can also be found in non-sun exposed areas such as the palms, soles, and under finger and toenails.

[15] ALM can also cause other non-specific symptoms if it spreads to certain areas of the body:[16] Acral lentiginous melanoma is a result of malignant melanocytes at the membrane of the skin (outer layers).

[21] More extensive melanomas may require wider excision (margins of 0.5 cm or more), digital amputation, lymphangiogram with lymph node dissection, or chemotherapy.

[22] The main characteristic of acral lentiginous melanoma is continuous proliferation of atypical melanocytes at the dermoepidermal junction.

[7] According to Scolyer et al.,[25] ALM "is usually characterized in its earliest recognisable form as single atypical melanocytes scattered along the junctional epidermal layer".

Secondary amputation may be considered if the surgery margins are not clear of cancerous cells, or if patients develop a recurrence of the melanoma.

The prognosis of acral lentiginous melanoma is based on multiple factors including sex, age, race, Breslow depth, staging, and sentinel lymph node positivity.

[7] Out of these factors, it is believed that sentinel lymph node positivity provides the strongest prediction of cancer recurrence and death.

[27][28] When compared to cutaneous malignant melanoma (CMM), ALM has a poorer prognosis in terms of survival rates.

[7] Since acral lentiginous melanoma is not linked to sun or UV exposure and the cause is not well-understood, there are no specific preventative measures.