Triple Synchronous Primary Melanomas in a 77-Year-Old Sea Captain: Importance of Total Skin Examination.

When it comes to skin diseases, melanomas are considered the most lethal. Triple synchronous primary melanomas (SPMs) are rare. Here we have reported a case of a 77-year-old white male with three SPMs. The patient presented with a nodular melanoma in the upper left back; total skin examination (TSE) revealed additional melanomas in the right retroauricular region and on the left arm. The patient was unaware of these two additional melanomas that were only found because of the routine TSE, and the index lesion focused examination would have missed both. We advocate that TSE should be practised routinely by all dermatologists for all new patients, and also, from time to time in patients attending long-term follow-up appointments. Early diagnosis means simpler treatments and more favourable outcomes.