Misdiagnosis and delay in diagnosing acral malignant melanoma are quite common and usually associated with a poor prognosis. Non-healing plantar ulcers, including diabetic feet ulcers, are a possible misdiagnosis, with reports of malignant melanoma cases mistaken for diabetic foot ulcers. A 54-year-old male patient, with Type 2 diabetes mellitus, was referred to our department with a painless, non-healing ulcer of 12 months' duration under the right fifth metatarsal bone. The ulcer had been managed for months as a diabetic foot ulcer with local wound care, antibiotics and pressure-relieving footwear. On clinical examination, there was a 2.5-cm diameter ulcer under the right fifth metatarsal head, extending to the fourth interdigital space, with a pigmented macule with irregular borders in the ulcer margins (Fig. 1).
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