Not Every Purple Plaque Is Recurrence: A Striking Skin Eruption on a Melanoma Skin Graft Site

A 64-year-old woman was referred with a suspected melanoma recurrence at her left shin skin graft site. She had a background of Stage IIIC melanoma which was initially managed with wide local excision and split skin graft from the right thigh and healed without complication. She then commenced 4 weekly adjuvant Nivolumab and after her fifth cycle, PET imaging revealed increased FDG uptake at the graft site. An associated abnormal skin change over the graft site was noted by the Oncology team.