A 47-year-old man visited the dermatology clinic with a complaint of multiple oral, fingernail and penile lesions. The lesions had appeared 10-days ago, associated with fever, a decrease in appetite and nausea. The patient’s history revealed that 11 years earlier he had undergone a surgical excision for cutaneous melanoma on the chest.
On physical examination, multiple discrete, pigmented lesions could be observed on the tongue, hard and soft palates. Similar lesions were observed on the penis. Examination of the hands also revealed multiple longitudinal dark bands on the nail bed of multiple fingers.
Histopathological analysis of one of the biopsied lesions on the fingers confirmed the presence of melanoma cells. The finding was consistent with the diagnosis of mucosal and ungual melanoma metastases. Further evaluation of the patient’s gastrointestinal symptoms showed gastric metastases. In addition, a molecular analysis was performed which identified a BRAF mutation, consistent with mucosal and ungual melanoma metastases.
Treatment was initiated with dabrafenib and trametinib. The patient was evaluated 5 months after treatment was started and a partial regression of the lesions was seen.
References
Parodi, M., & Errichetti, E. (2020). Eruptive Mucosal and Ungual Melanoma Metastases. New England Journal of Medicine, 383(2), 169-169.
