Melanoma is a rare entity in childhood, but the incidence is increasing in adolescents. The most important feature is the rapid, progressive growth of a pigmented lesion that is disproportionate to other nevi. The ABCDs of melanoma are an easy way to spot it. A is for Asymmetry or shape of the nevus. Nevi that develop irregular borders or bleeding are suspect. Variations in color and areas of red, white, or blue in an area of brown are suspicious. A lesion with a diameter > 6 mm (about the size of a pencil eraser) should be evaluated as well. Risk factors include moles, fair skin, freckling, and light hair, family history, immune suppression, excessive exposure to ultraviolet radiation, age, gender, past history of melanoma, and genetic anomalies.