Superficial Spreading Melanoma „Slumbered“ Behind the Shadow of Onychomycosis

Malignant melanoma is the most aggressive form of cutaneous cancer. Due to the continuously increasing rate of newly detected cases each year and because of its particular low survival rate, the scientific interest in this type of neoplasia is constantly growing. Sun exposure is identified as the major etiologic factor for malignant transformation of the melanocytes. According to the WHO, malignant melanoma is divided into four main groups, as the superficial spreading form is defined as the most “gentle” among them. The name of this subspecies does not have to “drowse” the attention of dermatologists considering the possible metastasic risk, even at a later stage. Due to lack of subjective complaints, patients do not seek active consultation on this occasion, as this type of lesions often remain missed within the clinical examination. Early diagnosis, however, as well as early surgical removal is the key to increasing the survival rate of the patients. We present a case of a 88 year-old female patient consulted with dermatologist on occasion of severe onychomycosis, as a pigment lesion on the anterior surface of the right leg. Clinically and dermatoscopically suspected superficial spreading melanoma was detected within the examination.