Diffuse melanosis cutis: a systematic review of the literature

Sebaratnam, Deshan F., Venugopal, Supriya S., Frew, John W., McMillan, James R., Finkelstein, Eve R., Martin, Linda K. and Murrell, Dedee F. (2013) Diffuse melanosis cutis: a systematic review of the literature. Journal of the American Academy of Dermatology, 68 3: 482-488. doi:10.1016/j.jaad.2012.08.018

Author Sebaratnam, Deshan F.
Venugopal, Supriya S.
Frew, John W.
McMillan, James R.
Finkelstein, Eve R.
Martin, Linda K.
Murrell, Dedee F.
Title Diffuse melanosis cutis: a systematic review of the literature
Journal name Journal of the American Academy of Dermatology   Check publisher's open access policy
ISSN 0190-9622
Publication date 2013-03
Year available 2012
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.jaad.2012.08.018
Volume 68
Issue 3
Start page 482
End page 488
Total pages 7
Place of publication Philadelphia, United States
Publisher Mosby
Collection year 2013
Language eng
Formatted abstract
Background: Diffuse melanosis cutis (DMC) is a rare presentation of metastatic melanoma characterized by a progressive blue-gray discoloration of the skin and mucous membranes.

Objective: To foster a better understanding of the clinical presentation, histological findings, and pathophysiology underlying DMC.

Methods: A systematic review of the literature was completed utilizing MEDLINE, CINAHL, Embase, and Google. Data were extracted using a protocol-driven spread sheet with all statistical analyses completed using SPSS.

Results: The review identified 68 original cases of DMC. The mean time from diagnosis of melanoma until development of DMC was 11.48 months (95% confidence interval [CI]: 0-48.16). The mean time to death following the onset of DMC was 4.43 months (95% CI: 0.00-11.11). Histological findings were relatively consistent demonstrating intracellular and extracellular melanin deposition in the dermis, with a pronounced perivascular distribution. The pathophysiological mechanisms underlying DMC could not be definitively elucidated; however, it is hypothesized that the melanin precursors, melanin, and melanosomes liberated by cytolytic metastatic melanoma deposits are phagocytosed by dermal histiocytes, manifesting clinically as diffuse melanosis.

Limitations: The cross-sectional nature of case reports, paucity of cases of DMC, and heterogeneity in reporting limit any conclusions being drawn regarding the pathophysiology of DMC definitively.

Conclusion: DMC heralds a poor prognosis for patients with metastatic melanoma and affected patients should be made aware of the implications of this condition on survival.
Keyword Diffuse melanosis cutis
Malignant melanoma
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online 7 December 2012.

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2013 Collection
School of Medicine Publications
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