Analysing the trends over the last 2 decades, we can observe a steady increase in the percentage of women who choose to undergo breast reconstruction procedures following mastectomy. This is indisputably attributed to the high quality modern breast cancer multimodality treatment protocols, which currently allow not only for achieving a disease-free status but also for improving on patients' general well-being by restoring one's image and self-esteem. Case report. A 55 year-old non-smoking, former breast cancer female patient, presented to our clinic, in full accordance with the oncological department, requesting a unilateral breast reconstruction procedure. Patient's history revealed a multimodality treatment comprising radio-, chemo-and hormonotherapy following mastectomy. After having signed the informed consent, the patient opted for a two-stage expander-implant reconstruction. Six weeks after expander replacement the patient presented with sudden onset cellulitis on the reconstructed breast accompanied by wound dehiscence and minor implant exposure. Implant salvage was attempted, initially through additional flap dissection and readvancement, afterwards by means of a myocutaneous latissimus dorsi flap and later on in an acceptable manner through a fasciocutaneous locoregional perforator flap using infrared thermal imaging. The reconstructive procedure will be resumed 6 months after surgery when nipple-areolar complex reconstruction and contralateral symmetrisation mammaplasty are envisaged. Conclusion. Whilst a large array of breast reconstruction options are currently available, it is impossible to recur to a one-size fits all procedure from which all breast cancer patients may benefit. Adequate patient selection is regarded as a major contributing factor to overall procedure success.

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Spontaneous regression of malignant melanoma was first reported over a century ago. Clinically, areas of blue or grey colouration in lesions may be indicative of regression. Dermoscopy is a very useful tool for diagnosing regression. An important criterion is the blue-white scar. About 10–35% of excised melanomas show features of regression histopathologically. We present a case of regressing melanoma, with clinical and dermoscopic features suggesting a collision tumour, diagnosed histopathologically. This case might improve our knowledge of the potential clinical manifestations, and the biology, of regressing melanoma.

Malignant melanoma is a deadly form of skin cancer, and prompt diagnosis is a key factor in providing adequate, life-saving therapy. A 75-year-old man, with long-standing type 2 diabetes mellitus, presented with a 2- to 3-year history of right heel ulcer. He had received various therapies for a diagnosis of diabetic foot ulcer, to no avail. Physical examination showed a black, fungating ulcerated lesion on his right heel, with minimal bleeding. No inguinal lymphadenopathy was palpated. A biopsy was done, which revealed BRAF-negative malignant melanoma, with a vertical growth phase, Breslow 3.1 mm, ulceration, 11 mitoses/mm 2 , Clark level IV, no lymphatic or vascular invasion observed. Right inguinal lymph node sampling suggested no involvement, but PET-CT suggested pulmonary, right inguinal lymph node and bone involvement. The patient was referred to the oncologists. Written informed consent for publication was given by the patient. Diabetic foot ulcers are a frequently encountered, but serious complication of diabetes mellitus. Delayed healing is often seen, despite adequate therapy. The differential diagnosis of diabetic foot ulcers is vast and includes neoplasia. When a foot ulcer fails to heal, other differential diagnoses must be considered, in order for the patient to receive adequate therapy. Here specialist consultations, including dermatology consultations, could improve chances of delivering the right therapy promptly. This is a factor underlying the emphasis on a multidisciplinary approach to foot ulcer therapy. Our presentation – reported according to the CARE guidelines – also illustrates the fact that failure to reach a timely diagnosis may deny the patient the opportunity to receive adequate treatment. In such cases, “delayed therapy becomes denied (or failed) therapy”, paraphrasing the old adage “Justice delayed is justice denied”.