Acral lentiginous melanoma is a rare subtype of cutaneous melanoma that usually has an unfavourable and aggressive course. The pathogenic mechanisms related to this clinical course are not fully understood. Currently, studies in the literature focus on the immune evasion mechanisms related to the melanoma microenvironment, as these may inhibit the antitumour immune response, allowing disease progression. The expression of human leukocyte antigen G and interleukin 10 and M2 macrophages in the tumour microenvironment are immune evasion strategies developed by some neoplasms. However, these factors have not been specifically studied in acral lentiginous melanoma.