This is a pigmented skin cancerous lesion rarely found in our population.

Symptoms:

Pain, itching, increase in size, irregular margins.

Tissue biopsy, MRI or CT scan for extent of lesion and locoregional spread
Metastatic workup like chest x-ray, ultrasound abdomen, Liver function test.
Discussion in tumor board meeting regarding chemo or radiotherapy

Usually done under general anesthesia and patient need to be admitted depends on size of the lesion and its spread. Surgical excision with wide local margins depending on the thickness of the cancer with lymph node clearance if sentinel lymph node positive or atypical cells in palpable lymph node Fine needle aspiration. Reconstruction is done with skin graft or flap. Follow up as out patient at different intervals for surveillance of cancer recurrence. Survival rate depends on the stage of the disease and its spread.