Advanced Pretibial Melanoma (APM): Clinicians Behaviour As Triggering Factor?


  • Georgi Tchernev Medical Institute of the Ministry of Interior, Medical Institute of Ministry of Interior (MVR), Department of Dermatology, Venereology and Dermatologic Surgery, Sofia; Onkoderma, Private Clinic for Dermatologic Surgery, Sofia
  • Ivan Pidakev Medical Institute of Ministry of Interior, Department of General, Vascular and Abdominal Surgery, General Skobelev 79, 1606 Sofia
  • Anastasiya Atanasova Chokoeva ”Onkoderma”- Policlinic for Dermatology and Dermatologic Surgery, Sofia
  • Uwe Wollina Department of Dermatology and Allergology, Teaching Hospital Dresden-Friedrichstadt, Academic Friedrichstrasse 41, 01067 Dresden
  • Torello Lotti University of Rome G. Marconi, Rome 00186
  • Georgi Konstantinov Maximov ”Onkoderma”- Policlinic for Dermatology and Dermatologic Surgery, Sofia
  • Ilia Lozev Medical Institute of Ministry of Interior, Department of General, Vascular and Abdominal Surgery, General Skobelev 79, 1606 Sofia



melanoma, seborrheic keratosis, imitation, surgery, risk behaviour, outcome


BACKGROUND: Pigmented lesions represent a broad spectrum of clinical conditions, both benign and malignant. The precise diagnosis is often a challenge, while the clinical diagnostic criteria could be misleading, as a result of the frequently atypical presentation of otherwise completely benign in nature lesions. The variety of therapeutic options for benign pigmented lesions including shave curettage, local laser destruction, electrocoagulation removal could sound enticingly both for the physician and patient, but they destroy the possibility for histological examination and provide a deceptively feeling of calm, that the problem is solved. If there is even a minimum chance for misdiagnosis, the risk could be a human life. Furthermore, a simple surgical excision could provide total resolution of the problem, with correct histological verification and further therapeutic measurements, if needed.

CASE REPORT: We present a case of a patient, with advanced pretibial melanoma with multiple lung metastases, misdiagnosed as a seborrheic keratosis, treated with shave-curettage 6 months earlier, as we want to emphasize the importance of the correct therapeutic method in all cases with pigmented lesions with unknown origin, in order to minimize the risk of dramatic consequences of misdiagnosis of melanoma. So, we want to ask you- is this risk justified?

CONCLUSION: So, we want to ask you - is this risk justified?


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How to Cite

Tchernev G, Pidakev I, Chokoeva AA, Wollina U, Lotti T, Maximov GK, Lozev I. Advanced Pretibial Melanoma (APM): Clinicians Behaviour As Triggering Factor?. Open Access Maced J Med Sci [Internet]. 2017 Dec. 31 [cited 2024 Jun. 15];6(1):64-6. Available from:

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