RT Journal Article
SR Electronic
T1 When acral malignant melanoma facades as diabetic foot!
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e242918
DO 10.1136/bcr-2021-242918
VO 14
IS 7
A1 Zainab Akram Yousif Yasear
A1 Lynda Bloomer
A1 Roshan Siddique
A1 Haroon Siddique
YR 2021
UL http://casereports.bmj.com/content/14/7/e242918.abstract
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.