This is a very malignant tumour which in Africans usually arises on the
foot, less often on the hand (usually acro-lentiginous melanoma). It can
start as a small pigmented papule or nodule which grows, often showing
typical blue-grey-black shades of colour, and sometimes bleeding or ulcerating.
It spreads to other organs rapidly and the diagnosis is often made
when the tumour has already spread to at least regional lymph nodes and
it is too late for cure. Early diagnosis is therefore important. Keep a
melanoma in mind when someone presents with a chronic ulcer on the
foot especially when it shows typical pigmentation or when it does not
respond to ulcer-treatment.
An incision biopsy should not be performed in a lesion which is suspect
for malignant melanoma, the lesion needs to be excised in total.
Management of malignant melanoma
- Wide surgical excision and histological examination.
- Refer to a specialised centre.
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