Nodular Melanoma

Nodular melanoma (NM) accounts for 3-4% of all melanoma cases. It occurs in a relatively younger age group (5th or 6th decades) than other melanoma subtypes and is of shorter duration. Males are affected more commonly than females (M:F = 2:1). It can present anywhere on the body surface but has a predilection for trunk and limbs. It appears as a smooth firm elevated nodule or a polypoid mass covered by epidermis. The color ranges from tan (amelanotic variants), brown, blue to black. Some cases show ulceration. By definition, it does not have a radial growth phase, hence a flat pigmented component is not seen clinically or microscopically in the adjoining skin. Amelanotic variants may be mistaken for pyogenic granuloma or other vascular lesions.