In conclusion, we have identified four novel epigenetic prognostic biomarkers in AM: HHEX, NELFB, IFITM1, and SIK3. Hypermethylation in the promoter region of these genes is significantly associated with aggressive clinicopathologic parameters including greater Breslow thickness, ulceration, increased mitotic rate, and lymph node metastasis and worse DSS in AM. The gene discussed is NELFB; the disease is metastatic malignant neoplasm in the lymph nodes.