Nodular melanoma

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Nodular melanoma (NM) is the most aggressive form of melanoma. It grows in vertical direction from the outset and grows very fast (months). Nodular melanoma has no known precursor. It is a small black, or if amelanotic, pink nodule that simply enlarges. The lesions tend to bleed.

Pathophysiology

Microscopic Pathology

The microscopic hallmarks are:

• Dome-shaped at low power
• Epidermis thin or normal
• Dermal nodule of melanocytes with a 'pushing' growth pattern
• No "radial growth phase"

Physical Examination

Skin

Evolution of a 4mm nodular melanoma.