Australian Medical Student Journal 49

A diagnosis of metastaƟ c melanoma confers a poor prognosis, with a median overall survival of six to ten months. [1-3] This aggressive disease process is of parƟ cular relevance in Australia, owing to a range of adverse risk factors including a predominantly fair-skinned Caucasian populaƟ on and high levels of ultra-violet radiaƟ on. [4-6] While improved awareness and detecƟ on have helped to stabilise melanoma incidence rates, Australia and New Zealand conƟ nue to display the highest incidence of melanoma worldwide. [4-7] Clinical trials have led to two breakthroughs in the treatment of melanoma: ipilimumab, a fully human monoclonal anƟ body, and vemurafenib, a targeted inhibitor of BRAF V600E. Case PresentaƟ on The paƟ ent, a 63 year old male, iniƟ ally presented to his general pracƟ Ɵ oner ten years ago with an enlarging pigmented lesion in the centre of his back. Subsequent biopsy revealed a grade IV cutaneou