Fields Kenneth, Milikowski Clara, Jewell Thomas, Fields Joseph
5100 Tamiami Trail N, Ste 102, Naples FL 34103, USA.
Cutis. 2014 Mar;93(3):145-50.
Diffuse melanosis associated with melanoma is a rare condition characterized by rapidly acquired skin pigmentation that usually occurs in the setting of advanced metastatic melanoma. We report a case of localized diffuse melanosis associated with melanoma on the lower left leg that successfully responded to treatment with imiquimod cream 5%. Initial treatment included application of imiquimod from the knee to the ankle once daily. Application frequency was increased to up to 3 times daily and eventually was switched to overnight occlusion until complete clearance was achieved. This rare condition is not completely understood, as only approximately 20% of cases have shown individual melanoma metastases within the pigmented skin. In our patient, as in the majority of cases, we were unable to detect individual metastases within the pigmented skin. This case is unique because diffuse melanosis was confined to an extremity. The clearing of the pigmented skin was impressive. Imiquimod may have activity against melanoma, melanoma in situ, and diffuse melanosis associated with melanoma, as demonstrated in our case.
与黑色素瘤相关的弥漫性黑变病是一种罕见病症，其特征为迅速出现的皮肤色素沉着，通常发生于晚期转移性黑色素瘤的情况下。我们报告一例左小腿局限性弥漫性黑变病伴黑色素瘤的病例，该病例对5%咪喹莫特乳膏治疗反应良好。初始治疗为每天一次从膝盖至脚踝涂抹咪喹莫特。涂抹频率增加至每天最多3次，最终改为夜间封包，直至色素沉着完全清除。这种罕见病症尚未完全明确，因为只有约20%的病例在色素沉着皮肤内显示有单个黑色素瘤转移灶。在我们的患者中，与大多数病例一样，我们在色素沉着皮肤内未能检测到单个转移灶。该病例独特之处在于弥漫性黑变病局限于一个肢体。色素沉着皮肤的清除效果令人印象深刻。如我们的病例所示，咪喹莫特可能对黑色素瘤、原位黑色素瘤以及与黑色素瘤相关的弥漫性黑变病有治疗作用。
