Abstract
Melanoma is the most aggressive form of skin cancer affecting patients worldwide and has the potential to metastasize to virtually any organ in the body. Early detection is of paramount importance to minimize patient morbidity and mortality. However, there has been increasing evidence highlighting that geographical and ethnic variations in the clinical presentation of melanoma do exist. Unlike the Western population, the major subtype of melanoma affecting the Asian population is in fact, acral lentiginous melanoma (ALM) and not superficial spreading melanoma (SSM).We hereby present a case of left hallux subungual melanoma with scalp metastasis. This case underscores the importance of the examination of acral skin and the nail apparatus for melanoma in Asians.
Highlights
CASE PRESENTATIONMelanoma is the most aggressive form of skin cancer affecting patients worldwide and has the potential to metastasize to virtually any organ in the body
Unlike the Western population, the major subtype of melanoma affecting the Asian population is acral lentiginous melanoma (ALM) and not superficial spreading melanoma (SSM)
Skin biopsy would be crucial to delineate if the nodules are primary cutaneous malignancies or cutaneous metastases from a distant primary malignancy, the latter would be more likely given the presentation of two discrete nodules
Summary
Melanoma is the most aggressive form of skin cancer affecting patients worldwide and has the potential to metastasize to virtually any organ in the body. A bedbound 87-year-old Chinese woman with advanced Parkinson’s disease was seen by the inpatient Dermatology consult service for 2 asymptomatic scalp nodules, which have been present for a few years. The atypical cells were strongly positive for Melan-A and Sox[10] and negative for AE1/3 and CK5/6 This malignant proliferation extended beyond the inferior resection margin and did not involve the overlying epidermis indicating that the process was not cutaneous in origin and likely due to haematogenous dissemination (Figure 2a, b, c). These findings were consistent with the diagnosis of metastatic melanoma.
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