Abstract

Altmışüç yaşında bayan hasta sağ el ikinci parmağında 6 aydır geçmeyen siyah kabarıklık şikayeti ile polikliniğimize başvurdu. Dermatolojik muayenesinde sağ el ikinci parmak dorsumunda periferinde pigmentasyon olan 1,5x1,5 cm boyutlarında siyah renkli nodül mevcuttu. Hasta, hayvanlarla temas tanımlamaktaydı ancak altta yatan bir nevus öyküsü bulunmamaktaydı. Öykü ve lezyonun klinik görünümüyle öncelikle orf düşünüldü, ancak dermoskopik inceleme sonucunda melanom şüphesi ile deri biyopsisi alındı. Histopatolojik inceleme sonucu malign melanom ile uyumluydu. Hasta Plastik ve Rekonstrüktif Cerrahi bölümüne konsülte edildi ve hastanın sağ el ikinci parmağı ampüte edildi. Aksiller lenf nodu örneklemesi sonucu non-spesifik reaktif lenfoid hiperplazi ile uyumlu geldi. Ayrıntılı sistemi karaştırmalar sonucunda metastaz saptanmadı. Malign melanom klinik olarak orfla karışabileceğinden akral lentiginöz melanom ayırıcı tanısında orf da akla gelmeli ve mutlaka dermoskopik inceleme yapılmalıdır.

Keywords

• Melanom, akral, ayırıcı tanı, orf

ACRAL LENTIGINOUS MALIGNANT MELANOMA MIMICKING ORF

Abstract

A 63 year-old female patient with the complaint of a black blistered lesion on the second finger of the right hand for six months is presented. Dermatological examination revealed hyperpigmented nodule 1.5x1.5 in size with peripherally pigmentation localized on the dorsal aspect of the second finger of the right hand. She had contacts with animals suggesting orf and gave no history of an underlying nevus that may be associated with melanoma. With the history and clinical appearance of the lesion, the first impression was orf but melanoma was suspected with dermoscopical examination.Punch biopsy was performed and the histopathological diagnosis was malignant melanoma. The patient was consulted with the Plastic and Reconstructive Surgery Department and the second finger of the right hand of the patient was amputated. Axillary sentinel lymph node sampling was associated with non-specific reactive lymphoid hyperplasia. Visceral metastasis was not detected according to the detailed systemic investigations.In conclusion, we suggest that malignant melanoma may mimic orf clinically and dermoscopy is a useful tool in differential diagnosis.

Keywords

• Melanoma, acral, differential diagnosis, orf

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