Abstract
Whether there has been an antecedent naevus or not, melanomata arise in one of three ways; in Hutchinson's melanotic freckle, as premalignant melanosis (pagetoid melanoma), or as a nodule without any preliminary spreading pigmentation. Each is a distinct clinicopathological entity. Melanoma arising in nodular form is the most malignant and that arising in Hutchinson's melanotic freckle is the least malignant. The greater malignancy of nodular melanoma is associated with a higher proportion of grade 3 tumours and a higher proportion with deep invasion. Whether there has been an antecedent naevus or not, melanomata arise in one of three ways; in Hutchinson's melanotic freckle, as premalignant melanosis (pagetoid melanoma), or as a nodule without any preliminary spreading pigmentation. Each is a distinct clinicopathological entity. Melanoma arising in nodular form is the most malignant and that arising in Hutchinson's melanotic freckle is the least malignant. The greater malignancy of nodular melanoma is associated with a higher proportion of grade 3 tumours and a higher proportion with deep invasion.
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