27 | primum non nocere

We report a case of Merkel cell carcinoma initially managed inappropriately in the outpatient setting with laser treatment before histological confirmation. The patient was subsequently referred to our Dermatology Unit for biopsy and specialist evaluation. The case is presented with focus on the diagnostic and therapeutic pathway following referral to our center. Particular attention is given to the difficulties generated by prior destructive treatment, which altered the lesion before definitive diagnosis. This case underlines the importance of histological assessment before performing ablative procedures on suspicious skin lesions. In aggressive neoplasms such as Merkel cell carcinoma, delayed diagnosis and inappropriate treatment may negatively affect clinical management and prognosis. Increased awareness among non-specialist physicians is essential in order to promote early referral and appropriate management of rapidly growing cutaneous lesions.