Malignant melanoma masquerading as a decubitus heel ulceration

The authors describe an atypical presentation of a malignant melanoma lesion identified as decubitus ulceration on the heel of a patient with diabetes mellitus complicated by peripheral neuropathy. The patient was treated at multiple institutions with routine debridement and conservative therapy with negligible improvement in wound appearance. The wound appeared viable, and a dermatological allograft procedure was attempted. Failure of the allograft prompted a soft tissue biopsy of the ulcerated area that revealed malignant melanoma. This is a rare yet solemn finding that may easily be overlooked in the neuropathic population.