Mr. J, age 42, is a construction worker in Las Vegas. He recently noticed that a mole on his face seemed to be getting larger and darker. At first he did not worry because he was in the sun a lot and assumed the change may have been caused by sunburn. After a month, not only was the mole larger and darker, but it appeared to be “bumpy.” His doctor diagnosed a malignant melanoma skin cancer following biopsy of the nevus. Mr. J reports pain in his right shin that does not go away when he puts his feet up or sleeps.