Multiple primary acral melanomas in two young caucasian patients.

BACKGROUND: Acral melanoma (AM) is still one of the most poorly studied melanomas. It generally presents beyond the fifth decade of life and usually is a BRAF wild-type melanoma. OBJECTIVE: To report the first cases of multiple primary AM in Caucasians. METHODS: Clinical, dermoscopic, pathological and molecular profiles. RESULTS: A healthy 34- year-old male presented an in situ subungual melanoma on his finger, and 22 months later a fast-growing nodular melanoma appeared in an existing nevus on the sole. Both melanomas carried the V600E BRAF mutation. A 19-year-old female patient presented 2 in situ melanomas on different parts of her left foot within a 6-year period of time. The patients have neither familiar melanoma nor germline mutations in CDKN2A/CDK4 genes. CONCLUSION: Multiple AM in Caucasians is very rare. BRAF mutations are possible, especially in a high-risk set of patients with multiple nevi. Specific acral examination must be recommended since AM still suffers delayed detection.

Unknown: a congenital nodule on the scapula.

We present a new case of a cutaneous bronchogenic cyst on the scapular area in a 2-year-old boy. The asymptomatic nodule over his right scapula had been detected at birth and had been gradually growing. Cutaneous bronchogenic cysts located near the scapula are extremely rare. The proposed mechanism is that the accessory buds from the tracheobronchial tree/primitive foregut migrated from the thorax in an aberrant manner to lie in a periscapular position. Cutaneous bronchogenic cysts are poorly recognized by clinicians because they lack pathognomonic clinical symptoms. The diagnosis is based on the histopathological findings in the majority of cases. Complete excision and histological examination are indicated to confirm the diagnosis, to relieve symptoms, and to prevent complications, such as infection or malignancy.