Acral, referring to the peripheral parts of the body, includes arms and hands, legs and feet, and nails, plus the ears and nose. This contribution, in dealing with the advances in diagnosis of common acrally distributed dermatologic lesions, covers the distribution, localization, shape, and patterns of such lesions. Knowing the morphology of skin lesions is an art that requires not only good observation but also a reasonable classification. For this reason, I have established the "Oumeish classification" to include (1) genodermatoses, (2) physically induced dermatoses, (3) temperature-induced dermatoses, (4) viral disease, (5) vascular entities, (6) neoplasms, and (7) miscellaneous conditions.
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