REPORT OF A CASE
An 87-year-old white woman who was diagnosed in 1980 with malignant melanoma (MM) on the plantar aspect of her right foot (invasion, Clark level II; thickness, 0.7 mm) was referred to the dermatology clinic at the University of Texas Medical Branch, Galveston, 10 years after undergoing the initial surgery. A nonpigmented 1.1 × 0.6-cm shallow erosion overlaying the metatarsophalangeal joint (Fig 1) was observed. Multiple 3-mm punch biopsy specimens of the erosion revealed an undifferentiated tumor adjacent to the epidermis that invaded the superficial dermis. Immunoperoxidase staining was positive for S100 protein and negative for keratin. The lymph nodes were not palpable, and no signs and symptoms of visceral metastatic disease were observed. Findings from her blood chemistry tests were within normal limits, except for borderline elevation of the alkaline phosphatase (279 U/L; normal, 68 to 243 U/L) and lactic dehydrogenase levels (207 U/L; normal, 109
Newman C, Wagner RF, Gordan W, Sanchez RL. Radiation Therapy as an Alternate Therapy for Locally Recurrent Acral Lentiginous Malignant Melanoma. Arch Dermatol. 1992;128(1):19–21. doi:10.1001/archderm.1992.01680110023001
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