Clinical appearance of cutaneous melanomas.

Brown and black spots are present on the skin of all people. Melanomas compromise only a very small percentage of all such pigmented lesions but are responsible for most of the deaths and illness caused by pigment cells. Three types of melanomas can be distinguished from their clinical, histologic, and biologic characteristics: lentigo maligna, superficial spreading melanoma, and nodular melanoma (1, 2). Melanomas of each variety exhibit distinguishing features that should alert the physician to the seriousness of the lesion. The single most important identifying characteristic of any melanoma is irregularity of color, shape, or topography.