Lower Extremity Amelanotic Nodular Melanoma

The incidence of melanoma has increased 15-fold in the past 40 years, which is more rapid than for any other malignancy. Nodular melanoma is the second most common subtype of melanoma and is often diagnosed at more advanced stages. Nodular melanoma contributes disproportionately to the number of deaths from melanoma. We discuss the case of a patient presenting with large amelanotic nodular melanoma of the lower extremity that had progression of disease despite undergoing appropriate management. It is important for Emergency physicians to maintain a high level of suspicion for nodular melanoma given the high mortality rates associated with this malignancy.