Volume 215 - Issue 9
A non‐healing ulcer: amelanotic melanoma
Authors: Michelle KY Chen and Deshan Frank Sebaratnam
Med J Aust 2021; 215 (9): 405-405. || doi: 10.5694/mja2.51294
Published online: 1 November 2021
Published online: 1 November 2021
A 73-year-old woman presented with a 7-month history of a non- healing ulcer on her left hallux
A 73‐year‐old woman presented with a 7‐month history of a non‐healing ulcer on her left hallux (Figure), having seen multiple medical professionals previously. She had no history of diabetes, peripheral vascular disease, or neuropathy. Biopsy demonstrated an amelanotic melanoma with a Breslow thickness of 4 mm and tumour mitotic rate of 1/mm2. No evidence of metastasis was evident on imaging, categorising her disease as stage IIC (T4bN0M0). She proceeded to amputation at the interphalangeal joint and continues lifelong clinical and radiological surveillance. This case demonstrates the importance of skin biopsy for any non‐healing ulcers. Differential diagnoses include neoplastic, infectious, vasculopathic, autoinflammatory and haematological aetiologies.1 Biopsy is recommended for ulcers with an atypical clinical presentation, recalcitrant to standard care and those with dynamic change over a period greater than one month.2,3
Competing interests
No relevant disclosures.
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