Introduction: Vaginal melanomas account for less than 3% of vaginal neoplasms and are characterized by poor prognosis.
Case report: We present the case of a 65-year-old patient with a history of invasive breast carcinoma and BRAF-negative vaginal melanoma, showing positive immunostaining for S100, SOX-10, PRAME, and vimentin, who was referred to the Dermatology Clinic of Mureș County Clinical Hospital for an erysipelas-like skin reaction on the upper limb affected by chronic lymphedema secondary to axillary lymphadenectomy. Clinical examination revealed diffuse melanosis cutis, acanthosis nigricans, and tripe palms. The patient also exhibited stigmata of Cushing syndrome, with a recent history of systemic corticosteroid therapy. Dermoscopy was performed and revealed dark brown, well defined, round macules on the genital mucosa, while the vaginal mass exhibited dermoscopic signs suggestive of melanoma.
Conclusions: Clinical examination and dermoscopy are essential for patients with mucosal melanomas, as they can uncover details that are critical for creating a comprehensive picture.