Melanoma is an aggressive form of skin cancer that is curable by surgical excision in the majority of cases, if detected at an early stage. To improve early stage melanoma detection, the development of a highly sensitive diagnostic test is of utmost importance. Here we aimed to identify antibodies to a panel of tumour associated antigens that can differentiate primary melanoma patients and healthy individuals. A total of 245 sera from primary melanoma patients and healthy volunteers were screened against a high-throughput microarray platform containing 1627 functional proteins. Following rigorous statistical analysis, we identified a combination of 10 autoantibody biomarkers that, as a panel, displays a sensitivity of 79%, specificity of 84% and an AUC of 0.828 for primary melanoma detection. This melanoma autoantibody signature may prove valuable for the development of a diagnostic blood test for routine population screening that, when used in conjunction with current melanoma diagnostic techniques, could improve the early diagnosis of this malignancy and ultimately decrease the mortality rate of patients.

Acral melanomas contribute to approximately 2–3% of melanomas but are commonly misdiagnosed due to their rarity, subtlety at onset and tendency to display amelanotic features. This case report describes a 70-year-old male with an amelanotic melanoma misdiagnosed as a non-healing arterial ulcer. Histopathology demonstrated a Breslow 2.3 mm, Clark level IV acral lentiginous melanoma, which was definitively managed with surgical intervention. This case report highlights the importance of considering melanoma in the differential diagnosis of non-healing ulcers.

It is well known that up to 2% of chronic burn scar lesions can transform into malignant tumours, however, melanoma formation at these sites is extremely rare. This case report describes a burns case, which progressed to four melanomas in a 78-year-old male patient’s little finger, 40 years after the initial incident. The patient underwent 3 mm punch biopsies, then digital amputation of the finger with pathology-proven melanoma. Histopathology investigation demonstrated three melanoma in situ and one invasive melanoma with a Breslow thickness of 1 mm. These findings are rare with few reports of melanoma in burn scars in the literature. This case report highlights the vigilance required from clinicians when performing skin examinations, and the importance of biopsies to newly pigmented lesions.

Akrale Melanome machen etwa 2-3% aller Melanome aus. Wegen ihrer Seltenheit und weil sie anfänglich unscheinbar und tendenziell amelanotisch erscheinen, werden sie häufig verkannt. Der vorliegende Fallbericht beschreibt den Fall eines 70-jährigen Mannes mit amelanotischem Melanom, das als nicht heilendes arterielles Ulcus fehldiagnostiziert wurde. Die histopathologische Untersuchung zeigte ein akrolentiginöses Melanom mit einer Tumordicke nach Breslow von 2,3mm, Clark-Level IV, das durch eine chirurgische Intervention definitiv behandelt wurde. Dieser Fall zeigt, dass es wichtig ist, bei der Differentialdiagnose nicht heilender Ulcera auch ein Melanom in Erwägung zu ziehen.

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