title: Acral malignant melanoma and striated palmoplantar keratoderma (Brunauer-Fohs-Siemens syndrome): a fortuitous association?
abstract: BACKGROUND
  Striated palmoplantar keratoderma or Brunauer-Fohs-Siemens syndrome is a very rare, focal, nonepidermolytic palmoplantar keratoderma with autosomal inheritance. Unlike other palmoplantar keratodermas, no association with visceral or skin cancer has ever been reported.
  
  
  OBJECTIVE
  We report a case of malignant melanoma arising in the hyperkeratotic lesions on the right heel of a patient with striated palmoplantar keratoderma. The lesion was completely excised; our patient also underwent sentinel lymph node biopsy and then was treated with high-dose interferon adjuvant therapy.
  
  
  METHODS
  Sentinel lymph node biopsy incision was made in elliptical fashion, long enough to harvest a full-thickness skin graft to cover the wide local excision defect. The skin graft was defatted by sharp dissection. Several perforations were made in graft and it was secured in place with sutures and bolster dressing.
  
  
  RESULTS
  At follow-up, the grafted skin showed hyperkeratotic changes but no local or systemic signs of the disease was observed.
  
  
  CONCLUSIONS
  The association between striated palmoplantar keratoderma and acral melanoma is discussed.
authors.affiliation: Department of Clinical Medicine and Immunological Sciences, Section of Dermatology, University of Siena, Siena, Italy. rubegni@unisi.it
authors.forename: Pietro
authors.initials: P
authors.lastname: Rubegni
authors.forename: Sara
authors.initials: S
authors.lastname: Poggiali
authors.forename: Aldo
authors.initials: A
authors.lastname: Cuccia
authors.forename: Maurizio
authors.initials: M
authors.lastname: Biagioli
authors.forename: Michele
authors.initials: M
authors.lastname: Fimiani
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006365:Heel; D006801:Humans; D007645:Keratoderma, Palmoplantar / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008545:Melanoma / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D012878:Skin Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D013577:Syndrome