Amelanotic Melanoma: A Type of Skin Cancer with No Pigment

Amelanotic melanoma doesn’t typically develop as a dark mole, as other types of melanoma do. Instead, it tends to develop as areas of reddish, pinkish, or nearly colorless spots. You may see a small spot of atypical characteristics, or you may not notice any evident changes at first.

Amelanotic melanomas may appear clear or the same color as the rest of your skin, or they may have a faint or light tint, including:

• pink
• purple
• red
• brown
• gray
• tan

It may often mimic benign skin growths or look like a small skin ulcer.

Even though the ABCDE rule that often helps identify melanoma cannot be fully applied to amelanotic growths, you may still want to look for and track changes. You may want to focus your attention on:

• spots that change in size or shape
• moles or skin tags of any color that change in diameter, texture, or thickness (including raised growths)
• persistently painful or itchy spots
• skin lesions, wounds, or ulcers that don’t heal
• spots that bleed, ooze, or become crusty, or repeat this bleeding and crusting cycle
• areas that feel or look lumpy, and that may or may not be painful to touch
• spots that look asymmetrical (one half is different from the other half)

Because it is difficult to identify or may be confused with benign spots, amelanotic melanoma tends to be diagnosed late, once it has become inoperable or metastasized. Skin cancer screening and self-exams may help with early detection.

Amelanotic melanoma may develop anywhere in the body, both internally and externally.

Any melanoma has the potential to be depigmented at some point, including:

• superficial spreading melanoma
• mucosal melanoma
• nodular melanoma
• acral melanoma
• spitzoid melanoma

Melanomas are a type of skin cancer that develop after the DNA in your skin cells becomes damaged. This leads them to grow out of control. Experts aren’t sure how damaged skin cell DNA turns into melanoma, but a combination of factors, including a genetic component, is likely.

Common causes and contributing factors for melanoma may include:

• exposure to ultraviolet (UV) light from sunlight and tanning beds
• having many benign moles all over the body
• tendency to develop atypical moles
• light skin
• red or blond hair color
• blue, green, or light eyes
• tendency to burn or freckle after sun exposure
• having a weakened immune system from medications or chronic conditions

Amelanotic melanoma may be more common among older people, but anyone may develop melanoma at any age.

Treatment for melanoma depends on the stage at the time of diagnosis. The most common treatment for early-stage melanoma is surgery. However, because of the difficulty in identifying depigmented tumors, this may not be the most used strategy for this cancer. This is also the case when the cancer has developed in an area that is difficult or risky to access.

If amelanotic melanoma is diagnosed early, a healthcare professional may remove the affected area and some skin around it using a sharp, tiny knife (scalpel). This surgery is called a wide local excision. It may be done in a doctor’s office or an operating room, depending on the size of the tumor and its location.

If the melanoma isn’t diagnosed at early stages, when it’s still localized, it may then spread to nearby organs and lymph nodes. These are small structures throughout your body that house immune cells and help clear toxins from your body.

In these cases, surgery may also be used to get your lymph nodes removed along with the melanoma site.

Advanced or stage 4 melanoma is typically treated with a combination of strategies, including:

• chemotherapy
• radiation therapy
• immunotherapy
• targeted therapy

These treatments aim to kill cancer cells or promote your body’s ability to fight them.

When the melanoma has spread to distant areas of your body, it is called metastasis. This may mean the cancer is inoperable, and your treatment may look to improve your symptoms but not stop the disease (palliative care).

Stage 1 amelanotic melanoma (localized) is easier to treat than more advanced melanoma.

For all melanoma skin cancers, the American Cancer Society lists the following 5-year relative survival rates:

You may reduce your chances of developing melanoma, although many factors that may not be in your hands could also play a role. However, melanoma prevention efforts can make a difference.

Here are some sun protection tips to consider:

• Apply a sunscreen of 50 SPF or higher before spending time outdoors. This is especially important if you plan to be in direct sunlight.
• Use sunscreen even on cloudy and rainy days, or indoors if you’ll be near a window. UV rays can still pass through clouds and glass.
• Whenever possible, choose shaded areas or use umbrellas when outdoors.
• Wear sun-protective clothing that covers arms and legs. This is especially important if you plan to be outside longer than 30 minutes.
• Avoid tanning beds and sun lamps.

Checking your body at least once a month for any new moles or spots is highly advised. You’re looking for spots that look different or that have atypical texture, color, or shape. Anything that changes and grows over time or doesn’t feel usual to you merits an appointment with a dermatologist.

Amelanotic melanoma refers to growths with little or no pigmentation compared to other skin areas. These melanomas do not appear like a dark mole or spot. Instead, you may notice flat or raised pinkish, reddish, or purplish spots that may or may not be painful to the touch.

When diagnosed early, amelanotic melanoma has a better outcome and may be surgically removed. More advanced stages may require more complex surgery or other treatments like chemotherapy and immunotherapy.

Monthly self-exams and consultations with a dermatologist if you notice an atypical spot or sign are highly recommended.