Nodular malignant melanoma in the nasolabial fold

A 93-year-old Caucasian female presented with a hemorrhagic nodule in the right nasolabial sulcus. The patient stated that the lesion had been present for a year and it had increased in size gradually. The hemorrhagic nodule was asymptomatic except for occasional bleeding. Physical examination of the patient revealed an ulcerated and hyperpigmented nodule with a size of 2x1x1 cm in the right nasolabial fold (Figs. 1 and 2). There were also hyperpigmented papules and patches surrounding the hemorrhagic nodule. The lesion was removed surgically in order to reach a definitive diagnosis (Fig. 3). The histopathological examination of the specimen revealed nodular malignant melanoma with Breslow thickness of 5 mm. Moreover, there was epidermal ulceration, intense pigmentation and slight lymphocytic infiltration. The patient was referred to medical oncology department for further treatment.