A 23-year-old white woman with Rothmund-Thomson syndrome (RTS)
presented with a 1-month history of a 4-mm hyperkeratotic, skin-colored papule on the cutaneous surface of her right upper lip (Figure 1). A shave biopsy specimen showed a malignant melanoma that extended to the base of the specimen (1.20
mm) (Figure 2). Wide local excision with 1-cm margins was performed, and the depth of the melanoma was determined to be 2.44 mm. The sentinel lymph node biopsy findings were negative for malignancy. Findings of a metastatic workup, including positron emission tomography, computed tomography of her chest, abdomen and pelvis, and bone scan with technetium Tc 99m hydroxymethylene diphosphonate, were negative.