Raynaud's phenomenon as a presenting sign of metastatic melanoma

The authors report a case of metastatic melanoma in a 22-year-old woman who initially presented with episodic attacks of digital ischemia. Review of the literature amassed another 22 cases of digital ischemia as an early or presenting feature of malignant disease. This is, however, the first description of Raynaud's phenomenon preceding by months the detection of a malignant melanoma. The possibility of occult malignant disease should be considered in evaluation of patients who present with digital ischemic changes without known predisposing conditions.