Chinai Brian, Piazza Michael, Patel Ritesh, Roy Satyajeet
Cooper University Hospital, Camden, New Jersey, USA.
Internal Medicine, Cooper University Hospital, Cherry Hill, New Jersey, USA.
BMJ Case Rep. 2019 Aug 30;12(8):e230396. doi: 10.1136/bcr-2019-230396.
Diffuse melanosis cutis (DMC) is an extremely rare and late complication of metastatic melanoma (MM). It involves the progressive blue-grey discolouration of the skin and mucous membranes, occurring approximately 1 year after diagnosis of MM. The pathogenesis of DMC is unknown, although specific growth factors, such as alpha-melanocyte stimulating hormone, hepatocyte growth factor and endothelin-1, released by cancer cells, along with release of melanin precursors in the bloodstream and dermal MM micrometastases producing melanin have been attributed. Even with appropriate therapy, DMC seems to be a poor prognostic factor, with a mean survival time of 4-5 months. Here, we report a case of BRAF-mutated MM who presented with DMC. The patient underwent BRAF/MEK inhibition followed by anti-PDL1 therapy, yet passed away approximately 1 year after diagnosis.
弥漫性皮肤黑变病（DMC）是转移性黑色素瘤（MM）极为罕见的晚期并发症。它表现为皮肤和黏膜逐渐出现蓝灰色色素沉着，通常在MM诊断后约1年出现。DMC的发病机制尚不清楚，尽管癌细胞释放的特定生长因子，如α-黑素细胞刺激素、肝细胞生长因子和内皮素-1，以及血液中黑色素前体的释放和真皮MM微转移灶产生黑色素被认为与之有关。即使进行适当治疗，DMC似乎也是一个预后不良的因素，平均生存时间为4至5个月。在此，我们报告一例出现DMC的BRAF突变型MM病例。该患者接受了BRAF/MEK抑制治疗，随后接受抗PDL1治疗，但在诊断后约1年去世。
