AMELANOTIC MELANOMA

The amelanotic melanoma (AMM) is a melanoma devoid of pigment. The correct diagnosis may not be suspected early on. This is why all lesions presumed to be pyogenic granulomas should be sent for histologic examination. Sometimes, an AMM may resemble a basal cell carcinoma. The AMM typically occurs in adulthood with a peak incidence in the fifth decade. They most commonly occur in the sun-exposed areas.

• Rapidly growing (6x faster than regular melanoma) but non-descript.
• Pink, "When you see pink, stop and think!"
• Sometimes has a hint of pigment.
• AMM represents a significant problem in terms of patient education and screening for melanoma as it does not fit the classic ABCDE criteria.
• Factors associated with increase risk of developing an AMM in one study included the absence of back nevi, presence of many freckles, a sun-sensitive phenotypic index and prior AMM.

Clinical

The lesion typically is a relatively rapidly growing pink, red or vascular-appearing papulonodule. ("When you see pink, stop and think"). Early lesions are often pink, symmetric and non-descript. Larger lesions often ulcerate or bleed. At times, there is a telltale bit of pigment at the base.

RegionalDerm

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