Diffuse Melanosis Cutis as the First Sign of Recurrence of Low-Risk Melanoma: Case Report and Systematic Review

Anna Graziella Burroni; Niccolò Capurro; Franco Rongioletti; Emanuele Cozzani; Paolo Pronzato; Astrid Herzum; Antonio Guadagno; Mattia Fabio Molle; Giorgio Oddenino; Aurora Parodi

doi:10.5826/dpc.1401a8

Diffuse Melanosis Cutis as the First Sign of Recurrence of Low-Risk Melanoma: Case Report and Systematic Review

Authors

Anna Graziella Burroni Section of Dermatology, Department of Health and Science (DissaL), Polyclinic Hospital San Martino, IRCCS, Università di Genova, Italy
Niccolò Capurro Section of Dermatology, Department of Health and Science (DissaL), Polyclinic Hospital San Martino, IRCCS, Università di Genova, Italy
Franco Rongioletti Dermatology Clinic, Vita-Salute San Raffaele University, Milan, Italy
Emanuele Cozzani Section of Dermatology, Department of Health and Science (DissaL), Polyclinic Hospital San Martino, IRCCS, Università di Genova, Italy
Paolo Pronzato Medical Oncology 2 Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
Astrid Herzum Section of Dermatology, Department of Health and Science (DissaL), Polyclinic Hospital San Martino, IRCCS, Università di Genova, Italy
Antonio Guadagno Division of Pathology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
Mattia Fabio Molle Section of Dermatology, Department of Health and Science (DissaL), Polyclinic Hospital San Martino, IRCCS, Università di Genova, Italy
Giorgio Oddenino Section of Dermatology, Department of Health and Science (DissaL), Polyclinic Hospital San Martino, IRCCS, Università di Genova, Italy
Aurora Parodi Section of Dermatology, Department of Health and Science (DissaL), Polyclinic Hospital San Martino, IRCCS, Università di Genova, Italy

Keywords:

melanoma, melanosis, melanoma metastasis, pigmentation

Abstract

Introduction: Diffuse Melanosis Cutis (DMC) is a rare and late complication of metastatic malignant melanoma (MM) characterized by progressive pigmentation of skin and sometimes mucous membranes. The distinctive feature is the widespread and progressive deposition of melanin precursors in the dermis.

Objectives: The purpose of this review is to define the clinical and demographic features of DMC and to promote a deeper insight into the clinical manifestation, histological findings, and pathophysiology behind DMC.

Methods: We have conducted a systematic review of the literature on published DMC in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. We also reported a case of DMC secondary to low-risk melanoma.

Results: Overall, including our case report, we reported 53 articles described 62 DMC patients. Breslow level of primary melanoma was reported having a mean value of 3.3 mm. The mean survival rate from onset of DMC resulted being 4.36 months.

Conclusions: Among the most widely accepted etiopathogenetic hypotheses are deposition of melanic precursors in the dermis following tumor lysis, melanocyte proliferation induced by neoplastic growth factors, and the presence of diffuse dermal micro-metastases of MM. However, unanimous consensus on the proposed etiopathogenetic models of DMC is still lacking.

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