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Skin Cancer Nodular Melanoma

Nodular Melanoma accounts for roughly 10-15% of all melanomas. It is more frequent in males than females, with a ratio of 2:1. They occur most often in the fifth or sixth decade. NMs affect any cutaneous site, but are more often found on the extremities. Lesions appear and evolve over months and tend to extend vertically in the skin. NM is most commonly dark brown, red-brown, or red-black and is dome-shaped, polypoid, or pedunculated. It is occasionally amelanotic or flesh colored and resembles flesh-colored dermal nevi or basal cell carcinoma. These amelanotic melanomas represent 2% of all melanomas. Lesions eventually erode, ulcerate and bleed. NM is the type of melanoma most frequently misdiagnosed because it resembles a blood blister, hemangioma, dermal nevus, or polyp. Firm pressure applied to a hemangioma will in many instances force the blood out of the lesion and eliminate the color. Melanomas are solid and their shape and color density can not be changed with firm finger pressure.