Aylin Türel Ermertcan, Kamer Gunduz, Barış Inan, Murat Yaman, Peyker Temiz

2012

Altmışüç yaşında bayan hasta sağ el ikinci parmağında 6 aydır geçmeyen siyah kabarıklık şikayeti ile polikliniğimize başvurdu. Dermatolojik muayenesinde sağ el ikinci parmak dorsumunda periferinde pigmentasyon olan 1,5x1,5 cm boyutlarında siyah renkli nodül mevcuttu. Hasta, hayvanlarla temas tanımlamaktaydı ancak altta yatan bir nevus öyküsü bulunmamaktaydı. Öykü ve lezyonun klinik görünümüyle öncelikle orf düşünüldü, ancak dermoskopik inceleme sonucunda melanom şüphesi ile deri biyopsisi alındı. Histopatolojik inceleme sonucu malign melanom ile uyumluydu. Hasta Plastik ve Rekonstrüktif Cerrahi bölümüne konsülte edildi ve hastanın sağ el ikinci parmağı ampüte edildi. Aksiller lenf nodu örneklemesi sonucu non-spesifik reaktif lenfoid hiperplazi ile uyumlu geldi. Ayrıntılı sistemi karaştırmalar sonucunda metastaz saptanmadı. Malign melanom klinik olarak orfla karışabileceğinden akral lentiginöz melanom ayırıcı tanısında orf da akla gelmeli ve mutlaka dermoskopik inceleme yapılmalıdır.

Anahtar Kelimeler:

Melanom, akral, ayırıcı tanı, orf

ACRAL LENTIGINOUS MALIGNANT MELANOMA MIMICKING ORF

A 63 year-old female patient with the complaint of a black blistered lesion on the second finger of the right hand for six months is presented. Dermatological examination revealed hyperpigmented nodule 1.5x1.5 in size with peripherally pigmentation localized on the dorsal aspect of the second finger of the right hand. She had contacts with animals suggesting orf and gave no history of an underlying nevus that may be associated with melanoma. With the history and clinical appearance of the lesion, the first impression was orf but melanoma was suspected with dermoscopical examination.Punch biopsy was performed and the histopathological diagnosis was malignant melanoma. The patient was consulted with the Plastic and Reconstructive Surgery Department and the second finger of the right hand of the patient was amputated. Axillary sentinel lymph node sampling was associated with non-specific reactive lymphoid hyperplasia. Visceral metastasis was not detected according to the detailed systemic investigations.In conclusion, we suggest that malignant melanoma may mimic orf clinically and dermoscopy is a useful tool in differential diagnosis.

Keywords:

Melanoma, acral, differential diagnosis, orf,

PDF

___

) Khandpur S, Reddy B. Acral lentiginous melanoma. Indian J DermatolVenereolLeprol. 2000;66:37-38.
Bravo Puccio F, Chian C.Acra ljunctional nevusversus acral lentiginous melanoma in situ: a differential diagnosis that should be based on clinicopathologic correlation Arch Pathol Lab Med. 2011;135:847-852.
Bickle K, Smithberger E, Lien MH, Fenske NA.Unilateral lichen planus pigmentosus mimicking acral lentiginous melanomaJ Drugs Dermatol 2010;9:841-843. Martorell
E.Cutaneousinvolvement in multiplemyeloma mimicking acral-lentiginous melanoma. J Am Acad Dermatol. 2010;62:1076-1078.
Pereyra-Rodríguez JJ, Pulpillo A, Zulueta-Dorado T, Conejo-Mir J.Acral lentiginous melanoma mimicking pyogenic granuloma.Med Clin (Barc). 2010;135:193.
Cho KH, Kim BK, Lee DY, Minn KW.A case of acral melanocytic hyperplasia: a unique pigmented lesion mimicking acral lentiginous melanoma in situ. J Dermatol. 1996;23:181-186. Taylor
progress: acral lentiginous melanoma. 1981;134:44.
Ise M, Yasuda F, Konohana I, Miura K, Tanaka M. Acral melanoma with hyper keratosis mimicking a pigmented wart. Dermatol Pract Concept. 2013;31:37-39.
Nambi GI, Rajeshwari KM, Mehta SS. Traumatic hematoma
mimicking acrallentiginous melanoma. J Cutan Aesthet Surg. 2012;5:144-146. F,
Gimeno-Carpio 5) 6) 7) DR.
Dermatology-epitomes of Med. West J 8) 9) in a palmoplantar
wart 10) Jang YH, Lee JY, Kim MR, Kim SC, Kim YC.Acral pigmenteds
mimicked acral lentiginous malignant melanoma.
Dermatol. 2011;23:246-249. that
clinically Ann 11) TS, Bae EJ, Ro KW, Seo SH, Son SW, Kim IH.Acral lentig inous melanoma developing during long-standing atypical melanosis: usefulness of dermoscopy for detection of early acral melanoma. Ann Dermatol. 2011;23:400-404.
) Phan A, Dalle S, Touzet S, Ronger-Savlé S, Balme B, Thomas L.Dermos copic features of acral lentiginous melanoma in a largeseries of 110 cases in a white population.Br J Dermatol. 2010;162:765-771.
) Kawabata Y, Tamaki K Distinctive dermatoscopic features of acral lentiginous melanoma in situ from plantar melanocytic nevi and their histopathologic correlation.J CutanMedSurg. 1998;2:199-204.
http://edergi.cbu.edu.tr/ojs/index.php/cbusbed isimli
yazarın CBU-SBED başlıklı eseri bu Creative Commons Alıntı-Gayriticari lisanslanmıştır. Uluslararası Lisansı ile

Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi-Cover

ISSN: 2147-9607
Yayın Aralığı: Yılda 4 Sayı
Başlangıç: 2014
Yayıncı: Manisa Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü

Arşiv