Synergism of Therapies After Postoperative Autograft Failure in a Patient With Melanoma of the Foot Misdiagnosed as a Pressure Ulcer.

INTRODUCTION: Amelanotic melanoma of the foot is a diagnostic challenge for physicians as it often appears as a benign lesion. In order to make the correct diagnosis at early stages, it is recommended to perform a biopsy of worsening lesions that are refractory to standard treatments, particularly nonhealing wounds.

CASE REPORT: The authors describe the case of a 57-year-old man with amelanotic melanoma of the foot that had been treated as a pressure ulcer for 3 months. He underwent wide local excision of the melanoma and an application of skin autograft. After skin autograft failure, optimal wound bed preparation was achieved through negative pressure wound therapy and compression bandages associated with hyperbaric therapy. Complete wound healing was obtained with an epidermal fractional skin grafting system combined with compressive inelastic bandages.

CONCLUSIONS: Physicians must remain highly cautious of ulcerated lesions of the foot and may consider epidermal fractional skin grafting as a valid therapeutic option in case of postsurgical wounds resulting from wide local excision of malignant melanomas.