{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:10:07Z","timestamp":1756372207501,"version":"3.44.0"},"reference-count":6,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,6,14]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:p>An 85-year-old Indian man presented with non-healing foot ulcer over the left heel. There was initial response to wound size with standard treatment including offloading, debridement and antibiotic therapy. However, subsequently, there was no progress noted. Incidentally, two small black spots in the wound bed raised the suspicion of melanoma. Incisional biopsy confirmed acral lentiginous melanoma (ALM). The final diagnosis was ALM coexisting with diabetic foot ulcer (DFU). The wound was treated by surgical resection and flap reconstruction that resulted in complete healing. Fourteen months after the initial intervention, the patient developed a new lump and ulceration around the previous wound bed. This turned out to be recurrent disease with distant metastasis. The patient died eventually with palliative support. Through this case, we would like to highlight the importance of early biopsy and intervention in DFU especially for those wounds with atypical presentation or refractory to standard treatment.<\/jats:p>","DOI":"10.1136\/bcr-2021-242918","type":"journal-article","created":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T12:37:23Z","timestamp":1626352643000},"page":"e242918","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["When acral malignant melanoma facades as diabetic foot!"],"prefix":"10.1136","volume":"14","author":[{"given":"Zainab Akram Yousif","family":"Yasear","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrinology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynda","family":"Bloomer","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, The Dudley Group NHS Foundation Trust, Dudley, West Midlands, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roshan","family":"Siddique","sequence":"additional","affiliation":[{"name":"School of Medicine, St George's University of London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haroon","family":"Siddique","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, The Dudley Group NHS Foundation Trust, Dudley, West Midlands, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,7,15]]},"reference":[{"key":"2025082801411155000_14.7.e242918.1","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1016\/S0140-6736(05)67701-X","article-title":"Malignant melanoma presenting as a foot ulcer","volume":"366","author":"Kong","year":"2005","journal-title":"The Lancet"},{"key":"2025082801411155000_14.7.e242918.2","doi-asserted-by":"crossref","DOI":"10.1186\/1757-1146-3-25","article-title":"Clinical guidelines for the recognition of melanoma of the foot and nail unit","volume":"3","author":"Bristow","year":"2010","journal-title":"J Foot Ankle Res"},{"key":"2025082801411155000_14.7.e242918.3","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000004332","article-title":"Initial misdiagnosis of melanoma located on the foot is associated with poorer prognosis","volume":"95","author":"Sondermann","year":"2016","journal-title":"Medicine"},{"key":"2025082801411155000_14.7.e242918.4","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.jdermsci.2013.07.013","article-title":"KIT, NRAS, BRAF and PTEN mutations in a sample of Swedish patients with acral lentiginous melanoma","volume":"72","author":"Zebary","year":"2013","journal-title":"J Dermatol Sci"},{"key":"2025082801411155000_14.7.e242918.5","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-013-3089-0"},{"key":"2025082801411155000_14.7.e242918.6","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2014.0172"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-242918","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:41:19Z","timestamp":1756370479000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-242918"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":6,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,7,15]]},"published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1136\/bcr-2021-242918"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-242918","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,7]]}}}