X-ray - Postoperative x-ray
What is the differential diagnosis based on imaging?
Differential diagnosis for this toe lesion includes malignancy such as squamous cell carcinoma or melanoma. Infection would be less likely.
Which skin cancer is responsible for the majority of skin cancer-related deaths?
Melanoma accounts for only about 1% of skin cancers but is responsible for the vast majority of skin cancer deaths.
What are the different subtypes of melanoma that can occur on the toes?
The most common subtype is acral lentiginous melanoma, which accounts for around half of all foot melanomas. Other subtypes that can involve the toes include nodular melanoma, which appears as a dark blue to black papule, and superficial spreading melanoma, which grows outward across the skin. Melanoma can also involve the nail unit, leading to discoloration, thickening, or deformity of the toenail, a condition known as ungual or subungual melanoma.
What is the treatment approach for melanoma of the toe?
The primary treatment is surgical excision, which may involve wide local excision for early stage lesions or partial or complete toe amputation for more advanced cases or those involving the nail unit.
Subsequent radiographs of the right foot show amputation of the hallux at the level of the metatarsophalangeal joint. The hallux sesamoids were also removed. There is soft tissue swelling at the amputation site.