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[A non-healing ulcer between the toes].

Pim A J Keurlings1,2, J E M Werner3, Judith U Ostertag4

  • 1Radboudumc, afd. Eerstelijnsgeneeskunde, Nijmegen.

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Summary

A non-healing foot ulcer in a 60-year-old man was diagnosed as amelanotic melanoma. Early biopsy is crucial for acral lesions that do not improve with treatment.

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Area of Science:

  • Dermatology
  • Oncology
  • Podiatry

Background:

  • Acral lesions, particularly on the feet, can present diagnostic challenges.
  • Amelanotic melanoma, lacking pigment, may mimic benign conditions, delaying diagnosis.

Observation:

  • A 60-year-old male presented with a persistent, non-healing interdigital ulcer on his right foot.
  • Initial treatments were ineffective, prompting further investigation.

Findings:

  • Histopathological examination of a biopsy revealed acrolentiginous amelanotic melanoma.
  • The patient underwent partial foot amputation, but metastatic disease was detected later.

Implications:

  • Benign-appearing acral lesions warrant close monitoring if they fail to heal.
  • Biopsy should be considered for persistent or non-healing acral lesions to rule out malignancy.
  • Timely diagnosis of amelanotic melanoma is critical for patient outcomes.