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Reminder of important clinical lesson
CASE REPORT
Amelanotic melanoma: a unique case study and review of the literature
  1. Katherine A Kaizer-Salk1,
  2. Robert J Herten2,
  3. Bruce D Ragsdale3,
  4. Roberta D Sengelmann1,4
  1. 1Santa Barbara Skin Institute, Santa Barbara, California, USA
  2. 2Dermatology and Dermatopathology, University of California Irvine School of Medicine, Irvine, California, USA
  3. 3Department of Dermatopathology, Western Diagnostic Services Laboratory, Santa Maria, California, USA
  4. 4Department of Dermatology, University of California Irvine School of Medicine, Irvine, California, USA
  1. Correspondence to Katherine A Kaizer-Salk, kks.kkaizersalk{at}gmail.com

Summary

Amelanotic melanoma (AM) is a rare form of melanoma which lacks visible pigment. Due to the achromic manifestation of this atypical cutaneous malignancy, it has been difficult to establish clinical criteria for diagnosis. Thus, AM often progresses into an invasive disease due to delayed diagnosis. In this report, we describe the case of a 72-year-old Caucasian woman who had been diagnosed with AM after 3 years of failed treatments for what presented as a periorbital dermatitis. Her Clark’s level 4, 1.30 mm thick melanoma required nine surgeries for successful resection and reconstruction. This case exemplifies the diagnostic pitfall of AM and the need for new criteria for early detection and management.

  • dermatology
  • general practice / family medicine
  • cancer intervention

https://doi.org/10.1136/bcr-2017-222751

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    Footnotes

    • Contributors RJH has been responsible for ongoing management of the patient as her medical dermatologist. BDR was the dermatopathologist on this case. RDS was the patient’s dermatologic surgeon. KKS was the medical assistant for RDS on this case as well as the project administrator, responsible for literature review, drafting of manuscript, and final editing. RJH, BDR, RDS: supervision, critical revision for content, final approval of article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.