Generic selectors
Exact matches only
Search in title
Search in content
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obervation Letter
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Special Article
Specialty Interface
Studies
Study Letter
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Tables
Technology
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF
Letter To Editor
2008:74:1;70-71
doi: 10.4103/0378-6323.38422
PMID: 18187836

Sporotrichoid pattern of malignant melanoma

Ranjan C Rawal, Kanu Mangla
 Department of Dermatology, V. S. Hospital, Ahmedabad, India

Correspondence Address:
Ranjan C Rawal
2, Friends Avenue, S.G. Road, Ahmedabad
India
How to cite this article:
Rawal RC, Mangla K. Sporotrichoid pattern of malignant melanoma. Indian J Dermatol Venereol Leprol 2008;74:70-71
Copyright: (C)2008 Indian Journal of Dermatology, Venereology, and Leprology
Figure 1: Multiple deep seated nodules of malignant melanoma in sporotrichoid pattern
Figure 1: Multiple deep seated nodules of malignant melanoma in sporotrichoid pattern

Sir,

Malignant melanoma is a highly invasive neoplasm of skin, strongly influenced by environmental factors that develop in a genetically susceptible host. Incidence of melanoma is rising in Caucasians although it is a rare presentation in India. [1]

A 28-year-old female presented with multiple painful lesions over her right leg of eight months duration. She was a farmer and claimed that the lesions started as a single painful nodule on the heel following a thorn prick. She ignored it then and subsequently the size and number of the lesions increased to involve the whole right lower limb as linearly arranged nodules. Cutaneous examination revealed multiple tender nodulo-ulcerative lesions with discharge, arranged in linear fashion from heel to thigh, present over the right leg [Figure - 1]. Other findings included edema of the feet, thickened lymphatic channels between nodules along with bilateral stony hard, tender inguinal lymph nodes. The patient was previously diagnosed as sporotrichosis and treated with antifungal (itraconazole) drugs for six months in another healthcare facility without any clinical response. A differential diagnosis of sporotrichosis and malignant melanoma was considered. Limb X-ray, KOH smear, gram stained smear and fungal culture were negative. Skin biopsy revealed atypical melanocytes in the epidermis and dermis in nests. General examination revealed multiple generalized lymphadenopathy (axillary, cervical and submandibular lymph nodes). Abdominal sonography showed liver metastasis. Chest X-ray was normal. A diagnosis of malignant melanoma was established and the patient was referred to the oncology department for further management.

The incidence of melanoma continues to rise at an epidemic rate as evidenced by a 101.5% increase from the 1970s to the 1990s. [2],[3] Melanoma represents the fifth most common type of cancer, the most common type in women 25-29 years of age and the most common type in Caucasian men 25-44 years of age. But it is rare in Indian patients. Nodular melanoma and melanoma d′emblee are rare types of primary cutaneous malignant melanoma that are invasive and lack intraepidermal component. [4] These lesions when first noted clinically are always palpable, convex in shape, of varying shades, rapidly increasing in size; neglected tumors may be several centimeters in diameter. Ulceration occurs fairly early. They can occur in any portion of the skin/mucosa. [4]

Our patient presented with history of trauma with multiple nodular ulcerative lesions arranged in a linear fashion along the lymphatics over the lower limb which clinically simulated lymphocutaneous sporotrichosis. However, histopathology helped us to reach the correct diagnosis.

References
1.
Johnson TM, Chang A, Redman B, Rees R, Bradford C, Riba M, et al. Management of Melanoma with a multi disciplinary melanoma clinic model. J Am Acad Dermatol 2000;42:820-6.
[Google Scholar]
2.
Rigel DS, Friedman RJ, Kopf AW. The incidence of malignant melanoma in United States: Issues as we approach the 21 st century. J Am Acad Dermatol 1996;34:839-47.
[Google Scholar]
3.
Chang AE, Karmel LH, Menck HR. The national cancer data base report on cutaneous and non cutaneous melanoma: A summary of 84, 836 cases from the past decades. Cancer 1998;8:1664-78.
[Google Scholar]
4.
McGovern VJ, Mihm MC, Baily C, Booth JC, Clark WH, Cochran AJ. The classification of malignant melanoma and its histological reporting. Cancer 1973;32:1446-57.
[Google Scholar]

Fulltext Views
302

PDF downloads
71
Show Sections