Amelanotic subungual malignant melanoma with multiple nodular local skin metastases

We present a 72-year-old man with a subungual amelanotic malignant melanoma (MM) on the right first toe with numerous local nodular metastases after trauma and without regional lymph node involvement. Most of the lesions were angiomatous (reddish blue), and some had a hyperkeratotic surface, clinically resembling Kaposi sarcoma. Results of biopsies performed on skin taken from the toe and from a metastatic lesion of the tibia revealed a classic case of amelanotic MM. This case has 2 interesting points: the clinical presentation of the metastatic lesions and the topical spreading of the lesions, which was initiated after traumatic injury of the prime lesion.