Incidence: more frequent in males than females, with a ratio of 2:1. Nodular melanomas occur most often in the fifth or sixth decade.
Site: Nodular melanomas affect any area of skin, but are more often found on the extremities.
Course: Nodular melanoma lesions appear and evolve over months and tend to extend vertically in the skin.
Appearance: Nodular melanoma 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.
Differential diagnosis: Hemangioma which is compressible with its color density changed with firm finger pressure.
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