When acral malignant melanoma facades as diabetic foot!

Publication date: Jul 15, 2021

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.

Concepts Keywords
Antibiotic Medicine
Bed Clinical medicine
Biopsy Cutaneous conditions
Died Diabetes
Fourteen Foot diseases
Acral lentiginous melanoma
Diabetic foot ulcer
Wound
Lentigo

Semantics

Type Source Name
disease MESH malignant melanoma
disease MESH diabetic foot
disease MESH foot ulcer
pathway KEGG Melanoma
disease MESH biopsy
disease MESH diagnosis
disease MESH ulcer
disease MESH Diabetes Mellitus
disease MESH skin cancer

Original Article

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