Nodular melanoma

{{Infobox medical condition (new)

| name = Nodular melanoma

| image = Skin Tumors-P6251257.jpg

| synonyms =

| symptoms =

| complications =

| onset =

| duration =

| types =

| causes =

| risks =

| diagnosis =

| differential =

| prevention =

| treatment =

| medication =

| prognosis =

| frequency =

| deaths =

}}

Image:NodularMelanomaEvolution.jpg

Nodular melanoma (NM) is the most aggressive form of melanoma.{{cite book |last1=DE |first1=Elder |last2=D |first2=Massi |last3=RA |first3=Scolyer |last4=R |first4=Willemze |title=WHO Classification of Skin Tumours |date=2018 |publisher=World Health Organization |location=Lyon (France) |isbn=978-92-832-2440-2 |edition=4th |volume=11 |url=https://publications.iarc.fr/Book-And-Report-Series/Who-Classification-Of-Tumours/WHO-Classification-Of-Skin-Tumours-2018 |language=en |chapter=2. Melanocytic tumours |pages=145-146 }} It tends to grow more rapidly in thickness (vertically penetrate the skin) than in diameter compared to other melanoma subtypes.{{Cite journal|last1=Egger|first1=Michael E.|last2=Dunki-Jacobs|first2=Erik M.|last3=Callender|first3=Glenda G.|last4=Quillo|first4=Amy R.|last5=Scoggins|first5=Charles R.|last6=Martin|first6=Robert C.G.|last7=Stromberg|first7=Arnold J.|last8=McMasters|first8=Kelly M.|date=October 2012|title=Outcomes and prognostic factors in nodular melanomas|journal=Surgery|volume=152|issue=4|pages=652–660|doi=10.1016/j.surg.2012.07.006|pmid=22925134|issn=0039-6060}} Instead of arising from a pre-existing mole, it may appear in a spot where a lesion did not previously exist. Since NM tends to grow in depth more quickly than it does in width, and can occur in a place that did not have a previous lesion, the prognosis is often worse because it takes longer for a person to be aware of the changes. NM is most often darkly pigmented; however, some NM lesions can be light brown, multicolored or even colorless (non-pigmented). A light-colored or non-pigmented NM lesion may escape detection because the appearance is not alarming, however an ulcerated and/or bleeding lesion is common.{{cite book |author=James, William D. |author2=Berger, Timothy G.|title=Andrews' Diseases of the Skin: clinical Dermatology |publisher=Saunders Elsevier |year=2006 |isbn=978-0-7216-2921-6 |display-authors=etal}}{{rp|696}} Polypoid melanoma is a virulent variant of nodular melanoma.{{rp|696}}

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"

__NOTOC__