Melanoma is uncommon in the pediatric population: it accounts for 1%-3% of all pediatric malignancies and approximately 1%-4% of all melanomas occur in pediatric patients. 1,2 Several recent studies have detected an increase in the incidence of pediatric melanomas over the past 3 decades at a rate of 2%-3% per year. [1][2][3][4] The current diagnosis and treatment of pediatric melanoma are often based on the experiences of adults. 1,5 However, pediatric melanomas face several diagnostic challenges. Unlike adult melanomas, pediatric tumors often present as an amelanotic papule with regular borders and uniform coloration. 6 Pediatric melanomas often have unusual histologic patterns, with workup including fluorescence in situ hybridization (FISH), comparative genomic hybridization (CGH),