{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T01:57:21Z","timestamp":1769997441271,"version":"3.49.0"},"reference-count":15,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,8,22]]},"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:p>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\u2009year 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\u20135 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\u2009year after diagnosis.<\/jats:p>","DOI":"10.1136\/bcr-2019-230396","type":"journal-article","created":{"date-parts":[[2019,8,31]],"date-time":"2019-08-31T07:35:15Z","timestamp":1567236915000},"page":"e230396","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Diffuse melanosis cutis: a rare manifestation of metastatic melanoma"],"prefix":"10.1136","volume":"12","author":[{"given":"Brian","family":"Chinai","sequence":"first","affiliation":[{"name":"Cooper University Hospital, Camden, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Piazza","sequence":"additional","affiliation":[{"name":"Cooper University Hospital, Camden, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ritesh","family":"Patel","sequence":"additional","affiliation":[{"name":"Cooper University Hospital, Camden, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satyajeet","family":"Roy","sequence":"additional","affiliation":[{"name":"Internal Medicine, Cooper University Hospital, Cherry Hill, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,8,30]]},"reference":[{"key":"2025082804120685000_12.8.e230396.1","doi-asserted-by":"crossref","first-page":"126","DOI":"10.3390\/cancers3010126","article-title":"Decoding melanoma metastasis","volume":"3","author":"Damsky","year":"2010","journal-title":"Cancers"},{"key":"2025082804120685000_12.8.e230396.2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(78)90171-X"},{"key":"2025082804120685000_12.8.e230396.3","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1053\/j.seminoncol.2016.02.031","article-title":"Cutaneous manifestations associated with melanoma","volume":"43","author":"Vyas","year":"2016","journal-title":"Semin Oncol"},{"key":"2025082804120685000_12.8.e230396.4","doi-asserted-by":"crossref","first-page":"e6470","DOI":"10.1097\/MD.0000000000006470","article-title":"Diffuse melanosis cutis related to dermal micrometastases as the first clinical symptom of distant metastatic malignant melanoma","volume":"96","author":"Maj","year":"2017","journal-title":"Medicine"},{"key":"2025082804120685000_12.8.e230396.5","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1016\/j.jaad.2012.08.018","article-title":"Diffuse melanosis cutis: A systematic review of the literature","volume":"68","author":"Sebaratnam","year":"2013","journal-title":"J Am Acad Dermatol"},{"key":"2025082804120685000_12.8.e230396.6","doi-asserted-by":"publisher","DOI":"10.1097\/00000421-198212000-00014"},{"key":"2025082804120685000_12.8.e230396.7","unstructured":"National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology. Cutaneous Melanoma. https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/cutaneous_melanoma.pdf (Accessed 7 Jul 2019)."},{"key":"2025082804120685000_12.8.e230396.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1408868"},{"key":"2025082804120685000_12.8.e230396.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2016.03.081"},{"key":"2025082804120685000_12.8.e230396.10","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2001.112349"},{"key":"2025082804120685000_12.8.e230396.11","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1002\/bjs.18004821119","article-title":"Malignant melanoma with melanosis and melanuria, and with pigmented monocytes and tumour cells in the blood. Autoradiographic demonstration of tyrosinase in malignant cells from peritoneal fluid","volume":"48","author":"Goodall","year":"1961","journal-title":"Br J Surg"},{"key":"2025082804120685000_12.8.e230396.12","first-page":"764","article-title":"Diffuse melanosis in a patient with multifocal liver and thyroid metastases of a malignant melanoma","volume":"10","author":"Jantke","year":"2012","journal-title":"J Dtsch Dermatol Ges"},{"key":"2025082804120685000_12.8.e230396.13","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)30122-X"},{"key":"2025082804120685000_12.8.e230396.14","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1111\/ijd.12614","article-title":"Diffuse melanosis cutis in the setting of BRAF(V600E) metastatic melanoma","volume":"53","author":"Sebaratnam","year":"2014","journal-title":"Int J Dermatol"},{"key":"2025082804120685000_12.8.e230396.15","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1111\/ajd.12187","article-title":"Diffuse melanosis cutis in the setting of BRAF(V600E) mutant melanoma and treatment with targeted therapies","volume":"56","author":"Minocha","year":"2015","journal-title":"Australas J Dermatol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-230396","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:12:14Z","timestamp":1756379534000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-230396"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8]]},"references-count":15,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2019,8,30]]},"published-print":{"date-parts":[[2019,8]]}},"alternative-id":["10.1136\/bcr-2019-230396"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-230396","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8]]}}}