Symptoms of Nodular Melanoma

Nodular melanoma is an aggressive form of skin cancer. It is the second most common form of melanoma. Roughly 15% of all melanomas are nodular melanomas.

Nodular melanoma is a fast-growing cancer that typically first appears as a bump or raised lesion on the skin. The lesion is typically firm and may be a blackish-blue or bluish-red color.

Learn more about the symptoms of nodular melanoma.

Melanoma skin check
Peter Dazeley/Getty Images 

Frequent Symptoms

Unlike other forms of melanoma, nodular melanoma cannot be identified using the ABCDE method of identification, which stands for:

  • A for asymmetry
  • B for border irregularity
  • C for color variability/change
  • D for different
  • E for evolving

Instead, nodular melanomas are identified through the EFG method, meaning:

  • E for elevated
  • F for firm
  • G for growing

Frequently, nodular melanoma presents as a fast-growing lump that may increase in size over weeks or months.

The lesions commonly appear on exposed areas of the skin, like the head and neck. But it is possible for nodular melanomas to appear anywhere.

The main symptom of nodular melanoma is a lump or skin lesion. These lumps may appear:

  • Dome shaped
  • Symmetrical
  • Firm
  • Bigger than most moles, typically 1 centimeter or larger
  • Single color, or variable in pigment, ranging from black, red, blue, or the color of the person's skin
  • Smooth
  • Rough
  • Crusted
  • Warty

Symptoms of nodular melanoma include:

  • Itching
  • Stinging
  • Oozing
  • Bleeding

Rare symptoms

In rare cases, nodular melanoma may not have a black or dark coloring.

Nodular melanoma may present as pink, red, purple, or be skin colored. This form of nodular melanoma is called an amelanotic melanoma, a subcategory meaning the melanoma lacks dark pigments typically seen in most melanomas.

Due to the lack of pigment typical of other melanomas, amelanotic melanomas, including nodular melanomas that are amelanotic, may be overlooked or mistaken for benign skin conditions.

It is estimated that roughly 5% of melanomas overall are amelanotic.

Complications

Nodular melanoma grows rapidly and, because of this, may not be diagnosed until it is at an advanced stage.

As the cancer advances, it can spread to:

  • Nearby lymph nodes
  • Nearby areas of the skin

If undetected and left untreated, the cancer will continue to advance. At its most advanced stage nodular melanoma, as with other melanomas, may spread to:

  • Distant lymph nodes
  • Organs like the liver, brain, and lungs

Cancer that spreads to other parts of the body can cause a variety of symptoms. These include:

  • Fatigue
  • Weight loss and lack of appetite
  • Nausea or vomiting
  • Difficulty swallowing
  • Abdominal pain
  • Swelling or lumps
  • Pain that doesn't go away
  • Cough or hoarseness that doesn't resolve
  • Skin changes, including bleeding and bruising for no apparent reason
  • Changes to bowel habits
  • Pain when urinating, blood in the urine, or more frequent need to urinate
  • Fever
  • Headaches
  • Night sweats
  • Vision and hearing problems
  • Mouth sores, bleeding, pain, or numbness in the mouth

When to See a Doctor

Any changes to the skin should be investigated by a healthcare provider.

This includes:

  • New spots
  • Existing spots that change in size, shape, or color

At-Home Skin Checks

The earlier skin cancer is detected, the greater chance of successful treatment. Doing regular skin checks at home can be helpful in detecting skin cancer early. Most healthcare professionals recommend going over your skin once per month.

To prepare for a skin check on yourself at home, consider doing the following:

  • Choose a room that is well lit and has a full-length mirror.
  • Have a handheld mirror handy to check areas that are hard to see with the naked eye.
  • Enlist the help of a trusted family member or friend to examine areas like your back and scalp.
  • The first time you check your skin, take note of existing moles, freckles, or marks so during your next skin check, you can note any changes.

The best time to try an at-home skin check is after a bath or shower. To perform a skin check, follow these steps:

  1. Face a mirror.
  2. Examine your face, ears, neck, chest, and stomach.
  3. Women should lift their breasts to examine the skin underneath.
  4. Examine the underarm area and both sides of the arms.
  5. Examine the hands, both the palms and tops of the hands.
  6. Check between your fingers and under your nails.
  7. Sit down and examine your shins, tops of your feet, and front of your thighs.
  8. Look between your toes and under toenails.
  9. Check the bottom of your feet, calves, and backs of your thighs (a handheld mirror may be helpful here).
  10. Use a handheld mirror to check your genital area, buttocks, and lower and upper back.
  11. Examine the back of your neck and ears or ask a family member to help.
  12. Part your hair and check your scalp.

If you see anything that worries you, make an appointment to see your healthcare provider.

If left undetected, nodular melanoma can spread (metastasize) to the lymph nodes and organs in the body like the lungs, liver, and brain. Metastasis can cause a variety of symptoms and can be serious.

If cancer has spread to other parts of the body, treatment is likely to be more successful if the cancer is caught early. If symptoms are not related to cancer, other conditions can be identified and treated.

A Word From Verywell

Nodular melanoma is a fast-growing and aggressive form of skin cancer. It typically presents as a lump or lesion on the skin that is firm and may or may not be colored. It may not be diagnosed until is it in the advanced stages due to the speed it can grow. As such, at-home skin checks are an important tool in diagnosing and treating skin cancer like nodular melanoma early.

If you perform a skin check and notice something suspicious, or if you have any unusual symptoms, such as fatigue, nausea, pain, or unexplained weight loss, don't hesitate to make an appointment with a healthcare professional for an exam. A doctor can help you determine if further testing or treatment is needed.

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8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Memorial Sloan Kettering Cancer Center. Nodular Melanoma.

  2. DermNet NZ. Nodular Melanoma. Updated 2011.

  3. DermNet NZ. ABCDEFG of melanoma. Updated June 2019.

  4. Memorial Sloan Kettering Cancer Center. Amelanotic melanoma

  5. American Cancer Society. Melanoma skin cancer stages. Updated August 14, 2019.

  6. American Cancer Society. Signs and symptoms of cancer. Updated November 6, 2020.

  7. American Cancer Society. If you have melanoma skin cancer. Updated August 14, 2019.

  8. American Cancer Society. How to do a skin self exam. Updated July 23, 2019.