Onset of Poliosis is linked to Durable Response to Immune-Checkpoint Blockade in Metastatic Melanoma Patients: A Multicenter Case Series

Clinical and dermoscopic images of multiple primary melanomas.(A) Ulcerated nodular melanoma on the upper limb.(B-C) Dermoscopy shows atypical pigment network and atypical vessels.(D-F) Clinical images of three melanomas on the back, trunk, and limb.(G-I) Dermoscopy reveals asymmetry, black pigmentation, blue-white veil, and irregular globules.Results: This case highlights the importance of meticulous totalbody skin examination in patients with melanoma, as multiple primary melanomas may coexist and remain clinically occult.Accurate differentiation between multiple primary melanomas and cutaneous metastases is essential due to its prognostic and therapeutic implications.The presence of multiple melanomas at different anatomical sites underscores the heterogeneous presentation of synchronous primary melanomas.Nodular melanoma warrants particular clinical vigilance given its aggressive behavior and frequently atypical presentation.[2] Conclusions: The coexistence of nodular melanoma with multiple additional melanomas highlights the need for comprehensive dermatological assessment and individualized patient management.Early recognition of multiple primary melanomas is crucial for accurate staging and optimal outcomes.