PT  - JOURNAL ARTICLE
AU  - Zainab Akram Yousif Yasear
AU  - Lynda Bloomer
AU  - Roshan Siddique
AU  - Haroon Siddique
TI  - When acral malignant melanoma facades as diabetic foot!
AID  - 10.1136/bcr-2021-242918
DP  - 2021 Jul 01
TA  - BMJ Case Reports
PG  - e242918
VI  - 14
IP  - 7
4099  - http://casereports.bmj.com/content/14/7/e242918.short
4100  - http://casereports.bmj.com/content/14/7/e242918.full
SO  - BMJ Case Reports2021 Jul 01; 14
AB  - An 85-year-old Indian man presented with non-healing foot ulcer over the left heel. There was initial response to wound size with standard treatment including offloading, debridement and antibiotic therapy. However, subsequently, there was no progress noted. Incidentally, two small black spots in the wound bed raised the suspicion of melanoma. Incisional biopsy confirmed acral lentiginous melanoma (ALM). The final diagnosis was ALM coexisting with diabetic foot ulcer (DFU). The wound was treated by surgical resection and flap reconstruction that resulted in complete healing. Fourteen months after the initial intervention, the patient developed a new lump and ulceration around the previous wound bed. This turned out to be recurrent disease with distant metastasis. The patient died eventually with palliative support. Through this case, we would like to highlight the importance of early biopsy and intervention in DFU especially for those wounds with atypical presentation or refractory to standard treatment.