We report an 82-year-old male from Iquitos, Amazon region of Peru, with a three-month history of mild-tomoderate painful skin lesions on the right lower limb. The clinical examination revealed four tumors of the right shin, exhibiting exophytic growth, verrucose appearance, and ulceration. Two subcutaneous nodules were noted. Enlarged inguinal lymphadenopathy was observed. The histopathological examination revealed a diagnosis of melanoma. This case emphasizes the need for comprehensive and multidisciplinary surveillance in regions with limited melanoma data leading to a subdiagnosis of this malignancy. Also, it highlights the importance of primary prevention such as sun protection in tropical areas to prevent cutaneous melanoma, advocating for increasing awareness and preventive measures.

Dermatitis herpetiforme is an autoimmune disease characterized by the presence of vesicular lesions and itching on the extensor surface of the limbs, buttocks, and lower back. The clinical case of a 21-year-old woman, a native of and from Iquitos, is presented. She presented multiple painful, itchy vesicles with an erythematous and purulent base on both elbows for a month. Subsequently, these lesions spread to both knees, and intense itching was added. The patient experienced alternating periods of remission and exacerbation. The correlation of the clinical picture, serological and biopsy results, along with the therapeutic response to dapsona, confirmed the diagnosis of dermatitis herpetiforme, with a favorable evolution and remission of the disease.