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A 49-year-old woman presents with a lesion that developed over her right toe over the past 4 weeks. It is painless, but has begun to bleed. On examination, a smooth, pink, friable, eroded nodule is seen on the nail bed.

View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Amelanotic melanoma
A 49-Year-Old with a 4-Week-Old Lesion on Her Toe
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