1/19. Metastatic melanoma in a patient with Clouston syndrome successfully treated with isolated hyperthermic limb perfusion.BACKGROUND: Clouston syndrome is an autosomal dominant disorder characterized by nail dystrophy, partial or total alopecia, and hyperkeratosis of the palms and soles. OBJECTIVE: Although a variety of unusual cutaneous manifestations have been described, the incidence of melanoma in this population is unknown. methods: This article reports a case of in-transit metastatic subungual melanoma in a patient with Clouston syndrome successfully treated with hyperthermic limb perfusion with melphalan. RESULTS: Six months postperfusion, the patient is doing well, with resolution of the extremity erythema and edema. Followup ultrasonography revealed reduction in size of the eight subcutaneous nodules, with the largest measuring 3.3 cm in maximum diameter, representing nearly a 50% reduction in tumor volume postperfusion. CONCLUSION: Although melanoma has also been associated with some forms of ectodermal dysplasia, such as ectrodactyly--ectodermal dysplasia--clefting (EEC) syndrome, the incidence of melanoma in patients with Clouston syndrome is unknown. Thus far, to our knowledge, this is the first case report of melanoma arising in a patient with Clouston syndrome.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
2/19. Olmsted syndrome-palmoplantar and periorificial keratodermas: association with malignant melanoma.BACKGROUND: Olmsted syndrome is a rare congenital disorder with mutilating palmoplantar keratoderma, periorificial keratotic plaques, and other variable features. OBJECTIVE: We describe a 65-year-old woman with Olmsted syndrome complicated by the occurrence of a malignant melanoma inside the plantar keratoderma. To our knowledge, this is the first reported case of such an occurrence in Olmsted syndrome. The published cases of this rare disorder are reviewed. CONCLUSION: An association between malignant epithelial tumors and Olmsted syndrome has already been reported. The association of malignant melanoma with other types of palmoplantar keratodermas has been reported. This may suggest a predisposition to melanocytic as well as squamous cell malignancies in congenital keratodermas. Oral retinoids appear to be the most promising treatment for Olmsted syndrome and for other symptomatic keratodermas.- - - - - - - - - - ranking = 6keywords = palm (Clic here for more details about this article) |
3/19. Malignant melanoma developing in an area of hereditary palmoplantar keratoderma (Mal de Meleda).Palmoplantar keratoderma (PPK) refers to a genetically heterogeneous group of skin diseases, which may be inherited in autosomal dominant or recessive fashion. We observed a case of a 74-year-old man with Mal de Meleda, who developed malignant melanoma inside the hyperkeratotic palmar skin of the right hand. Many authors have reported a higher incidence of cancer in cases affected by palmoplantar hyperkeratosis both for hereditary association and particularly for mechanical damage of the affected areas. The association with melanoma has already been described, but not in a true Mal de Meleda type syndrome as in the case reported in this paper.- - - - - - - - - - ranking = 6keywords = palm (Clic here for more details about this article) |
4/19. Nodular melanoma of the face: a rare finding in african americans.The incidence of melanoma has dramatically increased during the past several decades in the united states. Although the majority of cutaneous melanomas occur in Caucasians, african americans are also susceptible to this malignancy. Cutaneous melanomas in african americans typically occur on palms of the hands or soles of the feet. This report documents the rare occurrence of a nodular melanoma of the face in a dark-complexion African-American patient.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
5/19. Atypical moles in a patient undergoing chemotherapy with oral 5-fluorouracil prodrug.We present a patient with multiple pigmented lesions on the palms, soles, oral mucosa and nails after chemotherapy with oral 5-fluorouracil (5-FU) prodrug. Dermoscopically, most of the macules showed similar features, with pigmentation present predominantly on the crista superficialis, while a large, dark macule also showed pigmentation along the sulcus superficialis with irregular hyperpigmentation and depigmentation, suggesting malignancy. However, histologically, both types of lesion showed basal hyperpigmentation and the presence of a small number of large atypical melanocytes. We diagnosed these lesions as pigment flecks induced by 5-FU, and the pigmented lesions gradually diminished after the cessation of chemotherapy. Our findings suggested that immunosuppression and 5-FU led to the development of the atypical pigmented lesions.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
6/19. Acral malignant melanoma and striated palmoplantar keratoderma (Brunauer-Fohs-Siemens syndrome): a fortuitous association?BACKGROUND: Striated palmoplantar keratoderma or Brunauer-Fohs-Siemens syndrome is a very rare, focal, nonepidermolytic palmoplantar keratoderma with autosomal inheritance. Unlike other palmoplantar keratodermas, no association with visceral or skin cancer has ever been reported. OBJECTIVE: We report a case of malignant melanoma arising in the hyperkeratotic lesions on the right heel of a patient with striated palmoplantar keratoderma. The lesion was completely excised; our patient also underwent sentinel lymph node biopsy and then was treated with high-dose interferon adjuvant therapy. methods: sentinel lymph node biopsy incision was made in elliptical fashion, long enough to harvest a full-thickness skin graft to cover the wide local excision defect. The skin graft was defatted by sharp dissection. Several perforations were made in graft and it was secured in place with sutures and bolster dressing. RESULTS: At follow-up, the grafted skin showed hyperkeratotic changes but no local or systemic signs of the disease was observed. CONCLUSION: The association between striated palmoplantar keratoderma and acral melanoma is discussed.- - - - - - - - - - ranking = 9keywords = palm (Clic here for more details about this article) |
7/19. dermoscopy of an acral congenital melanocytic nevus.Congenital melanocytic nevi carry a risk for malignant transformation into melanoma, therefore early detection of suspicious features is crucial to reduce mortality rates. dermoscopy improves the early detection of melanoma while reducing the number of unnecessary excisions of benign pigmented skin lesions. Dermoscopically, congenital melanocytic nevi are often characterized by the presence of a cobblestone pattern, but to date, little is known about the dermoscopic features of acral congenital melanocytic nevi. We report an acral congenital melanocytic nevus typified by the presence of three different dermoscopic patterns that are commonly seen in acquired melanocytic nevi of palms and soles.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
8/19. Colonization of nonmelanocytic cutaneous lesions by dendritic melanocytic cells: a simulant of acral-lentiginous (palmar-plantar-subungual-mucosal) melanoma.Four cases of colonization of nonmelanocytic lesions by dendritic melanocytic cells are reported, one in a verruca vulgaris of the lip, one in a squamous cell carcinoma in situ of mucous membrane overlying a tonsil, one in a lesion of lichen simplex chronicus with a nevocellular nevus of the external ear, and one in a dermatofibrosarcoma protuberans (Bednar tumor). This is an important biological process of melanocytes that must not be confused with the acral-lentiginous (palmar-plantar-subungual-mucosal (P-S-M) melanoma. It is probably much more common than the paucity of published reports would indicate.- - - - - - - - - - ranking = 5keywords = palm (Clic here for more details about this article) |
9/19. Pseudomelanoma in a black patient.A worrisome lesion in a 62-year-old black man prompted a review of the differential diagnosis of pigmented lesions involving palmar skin.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
10/19. melanoma mimicking plantar wart.A 58-year-old white man had an enlarging lesion on the sole of the right foot mistakenly diagnosed clinically and histologically as verruca vulgaris. Lack of response to therapy led to a repeat biopsy which showed malignant melanoma, acral lentiginous type, level IV. The lesion was surgically removed, and 11 months later there was no evidence of recurrence. In the differential diagnosis of lesions of the palms and soles, one should include acral lentiginous melanoma, especially if the lesion is pigmented.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
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