Non-healing ‘diabetic’ ulceration which turned out to be a lentiginous melanoma: a case from a diabetic foot clinic

The non-healing character of the lesion with irregular patches of dark brown and black pigmentation (figure 1), together with the fact that the patient reported a recent left toe amputation due to malignant melanoma in his brother prompted an immediate referral to dermatology with a suspicion of malignant melanoma. Punch biopsy confirmed a primary invasive cutaneous malignant melanoma with estimated Breslow index of 2–3 mm, mitotic index of 2/mm3 and Clark level 4 (figure 2). Irregular patches of brown and black discolouration/pigmentation in any skin lesion should raise a suspicion of malignant melanoma The authors are thankful to Ali Al-Omari and Nick J Tiffin from Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK for provision of the histopathological image.