Rapidly Growing Lesion in a 57 yo woman

The patient is a 57 yo woman with a 6 month history of a papule on the right arm.
The lesion measures 6 mm in diameter and had not diagnostic features.
An excisional biopsy done since this was a rapidly growing lesion which was not clearly benign.
Pathology shows a malignant melanoma, 2.3 mm thick, Level IV.
Signed out as superficial spreading, but clinically looks more like a nodular melanoma.
She has been referred to a dermatologic oncologist for wide local excision, SLN and other studies.

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Originally uploaded by David Elpern.