Nodular melanoma

=Nodular melanoma
Specialty| Dermatology

Nodular melanoma (NM) is the most aggressive form of melanoma.[1] It tends to grow more rapidly in thickness (vertically penetrate the skin) than in diameter compared to other melanoma subtypes.[2] 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.

## Contents

* 1 Signs and symptoms
* 2 Diagnosis
* 3 Treatment
* 4 Prognosis
* 5 References
* 6 External links

## Signs and symptoms[edit | edit source]

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.[3]: 696 Polypoid melanoma is a virulent variant of nodular melanoma.[3]: 696

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## Diagnosis[edit | edit source]

Evolution of a 4 mm nodular melanoma.

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"

* Dermoscopy of nodular melanoma arising within a superficial spreading melanoma

* A nodular melanoma arising within a superficial spreading melanoma

* Nodular melanoma

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## Treatment[edit | edit source]

Therapies for metastatic melanoma include the biologic immunotherapy agents ipilimumab, pembrolizumab, and nivolumab; BRAF inhibitors, such as vemurafenib and dabrafenib; and a MEK inhibitor trametinib.[4]

## Prognosis[edit | edit source]

Important prognosis factors for nodular melanoma include thickness, ulceration and Sentinel lymph node (SLN) status.[2]

## References[edit | edit source]

1. ↑ DE, Elder; D, Massi; RA, Scolyer; R, Willemze (2018). "2. Melanocytic tumours". WHO Classification of Skin Tumours. Vol. 11 (4th ed.). Lyon (France): World Health Organization. pp. 145–146. ISBN 978-92-832-2440-2. Archived from the original on 2022-07-11. Retrieved 2022-08-19.
2. ↑ 2.0 2.1 Egger, Michael E.; Dunki-Jacobs, Erik M.; Callender, Glenda G.; Quillo, Amy R.; Scoggins, Charles R.; Martin, Robert C.G.; Stromberg, Arnold J.; McMasters, Kelly M. (October 2012). "Outcomes and prognostic factors in nodular melanomas". Surgery. 152 (4): 652–660. doi:10.1016/j.surg.2012.07.006. ISSN 0039-6060. PMID 22925134.
3. ↑ 3.0 3.1 James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 978-0-7216-2921-6.
4. ↑ Maverakis E, Cornelius LA, Bowen GM, Phan T, Patel FB, Fitzmaurice S, He Y, Burrall B, Duong C, Kloxin AM, Sultani H, Wilken R, Martinez SR, Patel F (2015). "Metastatic melanoma - a review of current and future treatment options". Acta Derm Venereol. 95 (5): 516–524. doi:10.2340/00015555-2035. PMID 25520039. Archived from the original on 2018-07-19. Retrieved 2018-11-04.

## External links[edit | edit source]

Classification|

* ICD-10: C43 (ILDS C43.L10)
* ICD-O: M8721/3

|

* v
* t
* e

Skin cancer of nevi and melanomas

Melanoma|

* Mucosal melanoma
* Superficial spreading melanoma
* Nodular melanoma
* lentigo
* Lentigo maligna/Lentigo maligna melanoma
* Acral lentiginous melanoma
* Amelanotic melanoma
* Desmoplastic melanoma
* Melanoma with features of a Spitz nevus
* Melanoma with small nevus-like cells
* Polypoid melanoma
* Nevoid melanoma
* Melanocytic tumors of uncertain malignant potential

Nevus/
melanocytic nevus|

* Nevus of Ito/Nevus of Ota
* Spitz nevus
* Pigmented spindle cell nevus
* Halo nevus
* Pseudomelanoma

* Blue nevus
* of Jadassohn–Tièche
* Cellular
* Epithelioid
* Deep penetrating
* Amelanotic
* Malignant

* Congenital melanocytic nevus (Giant
* Medium-sized
* Small-sized)

* Balloon cell nevus
* Dysplastic nevus/Dysplastic nevus syndrome

* Acral nevus
* Becker's nevus
* Benign melanocytic nevus
* Nevus spilus

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