Diffuse melanosis cutis: a rare manifestation of metastatic melanoma

Abstract

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 year 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 4–5 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 year after diagnosis.

Diffuse Melanosis Cutis as the First Sign of Recurrence of Low-Risk Melanoma: Case Report and Systematic Review

“…A total of 185 articles were identified from the literature search since 1937 up to date. Ultimately, 52 articles about DMC, describing 61 DMC patients, satisfied above-described inclusion criteria and were included in the review ( Table 1 ) [ 1 , 3 – 53 ].…”

Diffuse Melanosis Cutis in the Era of Targeted Therapy

“…Melanin precursors can also be excreted in urine causing melanuria [ 2 ]. Other theories include the possibility that melanocyte proliferation might be stimulated by growth factors released by cancer cells or that DMC may be caused by dermal micrometastasis producing melanin [ 4 ]. Furthermore, more than one pathway may contribute to the etiopathogenesis of DMC.…”

“…DMC is a bad prognosis marker, with a mean life expectancy after developing hyperpigmentation of 4 to 5 months [ 2 ]. It is a presentation of metastatic melanoma, considered by some authors as a paraneoplastic condition, that can assist in the diagnosis of advanced melanoma [ 4 ].…”

Kutane Metastasen: Von der Epidemiologie bis zur Therapie

“…9 Als seltene Sonderform der kutanen Metastasierung beim malignen Melanom ist auch die Melanosis cutis diffusa zu nennen, bei der es zu einer bläulich-gräulichen Verfärbung der Haut und Schleimhäute kommt. 19 Bei Metastasen primärer Hauttumoren findet sich histologisch zumeist kein Kontakt zur Epidermis.…”