A case of Acral lentiginous melanoma in situ produced at the right foot bottom.

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The case of a 84-year-old Japanese female with acral lentiginous melanoma in situ is reported. The patient noticed a pigmented plaque ten months ago. At the first visit to our clinic, a 4×2cm-sized, irregulary shaped and pigmented plaque with color variegation from black to light brown was observed on the sole of her right foot. The lesion was totally excised with an approximate 1cm safety margin. We did not cover the surgical defect with a skin flap, but applied artificial dermis "Terdermis ® ".Histopathologic findings showed pagetoid arrangements of round and oval atypical melanocytes proliferating mainly in lower epidermis. However, atypical melanocytes were absent in upper dermis. Patients with malignant melanoma in situ can be treated by the excision of the lesion with a narrow margin. We performed a full thickness skin graft on the artificial dermis to close the surgical defect after the determination of the diagnosis of ALM in situ. The patient had no difficulty in walking after the operation.Thus, we obtained satisfactory results owing to the application of the two-step operation.
日本皮膚悪性腫瘍学会の論文