A chronic non-healing ulcer plantar.

Acral melanoma is challenging in two ways: it is in some cases difficult to diagnose and, once metastases have occurred, the prognosis is poor as therapy is less effective compared to melanoma from other parts of the skin. Here we report a case, were the correct diagnosis was made after melanoma has spread already to distant sites. Instead of surgery, we decided to start with immunotherapy consisting of Ipilimumab and Nivolumab. A complete response could be achieved without surgery of any tumors, including the primary melanoma.