Wrist arthritis and drug-related malignant melanoma in an ankylosing spondylitis patient: An unusual and rare case report

Ankylosing spondylitis (AS) is a chronic inflammatory disease that is the most frequent and severe subtype of seronegative spondyloarthropathies.[1,2] It typically affects the axial joints, most notably the sacroiliac joints; however, other sites of involvement, including peripheral joints and extra-articular manifestations, are also observed.[3-5] Pharmacological management of AS includes disease-modifying anti-rheumatic drugs (DMARDs) such as anti-tumor necrosis factor (TNF) agents to control the disease progression. However, patients with AS may still present impairments accompanied by pain and decreased function and quality of life (QoL).[1-4] In some cases, the systematic effect of AS disease and Ankylosing spondylitis (AS), which is a chronic inflammatory disease, is the most frequent and severe subtype of seronegative spondyloarthropathies. Although it typically affects the axial skeleton, the spine, peripheral joints, and entheses are frequently involved as well as extra-articular manifestations. In this case report, we present the clinical picture of malignant melanoma on the plantar surface of the foot, which is a rare side effect of anti-tumor necrosis factor therapy, as well as wrist arthritis, a very rare manifestation of AS. In addition, it dramatically illustrates how devastating AS can be for peripheral joints, while demonstrating the impact of arthroplasty and arthrodesis procedures on the patient's functional status.