Persistent Black Patch on Hand: Differential and Urgency of Biopsy

A stable, round, black macule/patch >2 years warrants **dermatology evaluation** to exclude:

• Melanoma: Asymmetry, border irregularity, color variegation, diameter >6 mm, evolution (ABCDE). Even subtle changes need biopsy.
• Melanocytic nevus: Benign but may mimic melanoma.
• Seborrheic keratosis: Waxy, “stuck-on,” often pigmented.
• Dermatofibroma: Firm, dimple sign.
• Pigmented basal cell carcinoma
• Acral lentiginous melanoma (palm/sole/nail) — higher morbidity.

**Dermoscopy + biopsy** is standard. Do not delay; early melanoma is curable.