title: Diffuse melanosis cutis related to dermal micrometastases as the first clinical symptom of distant metastatic malignant melanoma: Case report.
abstract: BACKGROUND
  Diffuse melanosis cutis (DMC) is a very rare sign of malignant melanoma progression. The condition usually develops after approximately one year from melanoma diagnosis in a patient with metastatic tumors and after anticancer treatment with cytostatic medications.
  
  
  METHODS
  A 72-year old Caucasian man was admitted to the Department of Dermatology with DMC for 4 months and the history of two melanomas treated surgically 30 years and 9 months before present hospitalization.
  
  
  METHODS
  Histological and immunohistochemical examinations of DMC biopsy indicated melanoma metastatic cells as well as free deposits of melanin and melanophage presence in the dermis.
  
  
  METHODS
  The patient refused to the treatment.
  
  
  RESULTS
  The patient died eight months after DMC appeared.
  
  
  CONCLUSIONS
  DMC is a rare presentation of advanced MM and is a bad prognostic factor. The pathomechanisms of the discoloration of the skin are not fully explained. The role of micrometastases, as well as melanin precursors, released during lysis of MM metastases, and growth factors may play a role in the development of the symptom.
authors.affiliation: Department of Dermatology, Venereology and Allergology, Wroclaw Medical University Department of Pathomorphology, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Maj
authors.forename: Alina
authors.initials: A
authors.lastname: Jankowska-Konsur
authors.forename: Joanna
authors.initials: J
authors.lastname: Gruber
authors.forename: Zdzisław
authors.initials: Z
authors.lastname: Woźniak
authors.forename: Piotr
authors.initials: P
authors.lastname: Nockowski
authors.forename: Anita
authors.initials: A
authors.lastname: Hryncewicz-Gwóźdź
mesh_terms: D000368:Aged; D020405:Dermis / Q000473:pathology; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008543:Melanins / Q000032:analysis; D008544:Melanocytes / Q000473:pathology; D008545:Melanoma / Q000150:complications / Q000473:pathology / Q000556:secondary*; D008548:Melanosis / Q000209:etiology / Q000473:pathology*; D061206:Neoplasm Micrometastasis / Q000473:pathology*
chemical_list: D008543:Melanins