Recurrent melanoma presenting as a rash: a case report

Melanoma is the most aggressive form of common skin cancer and recurrence, while rare, typically presents as pigmented papules or nodules near the primary site. Here, we describe a case of a woman with stage IIIC melanoma undergoing intralesional talimogene laherparepvec (T-VEC) therapy who developed a spreading erythematous rash on her left leg, accompanied by fatigue and leg swelling. Skin biopsy revealed recurrent melanoma, with SOX10 and Melan-A positivity, and imaging showed features concerning for multifocal disease recurrence in the left popliteal fossa. This case highlights an unusual presentation of melanoma recurrence and underscores the importance of biopsy in ­evaluating new skin findings in patients with a history of melanoma.