Amelanotic melanoma misdiagnosed as a diabetic foot ulcer

NewsBot · Sep 11, 2007

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Amelanotic melanoma misdiagnosed as a diabetic foot ulcer.
Yeşil S, Demir T, Akinci B, Pabuccuoglu U, Ilknur T, Saklamaz A.
J Diabetes Complications. 2007 Sep-Oct;21(5):335-7.

Amelanotic melanoma often leads to delayed clinical diagnosis because of its wide range of clinical appearances and lack of pigmentation. Misdiagnosis of amelanotic melanoma is also common, particularly when it is located at the foot. We report here a 71-year-old male patient with a 17-year history of type 2 diabetes mellitus who presented with a small ulcer under his fifth metatarsal head, which was previously misdiagnosed as a diabetic foot ulcer. The patient was treated with local wound care and systemic antibiotics without any improvement of the ulcer. Further investigation of the patient in our clinic revealed plantar amelanotic melanoma.
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mahtay2000 · Sep 11, 2007

I am lucky that the first time I saw an amelanotic melanoma I was a student on prac with a surgeon and the Heloma Molle I saw was quickly re-diagnosed and biopsied!

Experience and an open mind is the best defense!

NewsBot · May 30, 2018

Mistaken Diabetic Ulcers: A Case of Bilateral Foot Verrucous Carcinoma.
Di Palma V et al
Case Rep Dermatol Med. 2018 Jan 23;2018:4192657.

Verrucous carcinoma (VC) is a rare, low-grade, and well-differentiated variant of squamous cell carcinoma. These tumors are slow-growing and exophytic and have a negligible incidence of metastasis. Treatment is complete surgical resection, ideally by Mohs micrographic surgery, to ensure adequate clear margins. Cutaneous VC predominantly occurs on the plantar surface of the foot and rarely occurs in multiple sites. This case study describes the fourth reported occurrence of bilateral VC of the feet in a woman with chronic diabetic foot ulcers. The case provides further support for persistent wounds contributing to the development of this lesion and describes their role in the characteristic delay in diagnosis of VC
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NewsBot · Aug 8, 2018

Cutaneous squamous carcinoma in a patient with diabetic foot: an unusual evolution of a frequent complication.
Mantovani A et al
Endocrinol Diabetes Metab Case Rep. 2018 Jul 31;2018.

After basal cell carcinoma, the cutaneous squamous cell carcinoma (cSCC) is the second most frequent non-melanoma skin cancer worldwide, and, classically, arises from the upper coats of the epidermis of sun-exposed areas or from skin areas constantly exposed to a chronic inflammatory stimulus. The occurrence of cSCC seems to be linked to several factors, including exposure to sunlight (or other ultraviolet radiations), immunosuppression, chronic scarring conditions and some familial cancer syndromes. Although the majority of cSCCs are adequately eradicated by surgical excision, a subgroup of cSCC may be linked with an increased risk of recurrence, metastasis and death. The incidence of type 2 diabetes mellitus is constantly increasing worldwide. Importantly, diabetes mellitus is a strong risk factor for cancers (including cutaneous tumors) and is highly related with poor cancer outcomes. At present, in the literature, squamous cell carcinoma developing in association with diabetic foot ulcers has been already reported in some reports; however, additional data are needed to make the clinicians aware of this rare, although possible, complication. Therefore, we herein report an unusual case of an elderly man with T2DM and a positive oncological history, presenting a cSCC involving the skin overlying the first toe of left foot. The growing cSCC appeared approximately 3 years after the appearance of a diabetic ulcer.

LEARNING POINTS:
Diabetic foot ulcers are an important and severe complication of diabetes mellitus and often can result in foot amputation.Chronic and non-healing diabetic foot ulcers are often observed in clinical practice.Clinicians should always take into consideration the malignant degeneration (e.g., cutaneous squamous cell carcinoma) of any chronic non-healing diabetic foot ulcer in elderly T2DM individuals.Timely surgical resection of a chronic, non-healing diabetic foot ulcer might preclude the development of a cutaneous squamous cell carcinoma.
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