Abstract Number: 78

Multiple melanoma in a burns scar

P. Cantwell

Meeting: 2021 Dermcoll

Session Information

Date: -

Session Title: Poster Presentations

Session Time: -

It is well known that up to 2% of chronic burn scar lesions can transform into malignant tumours [1], however, mela- noma formation at these sites is extremely rare. This case report describes a burns case, which progressed to four melanomas in a 78-year-old male patient’s little finger,
40 years after the initial incident. After change of appear-
ance of these lesions, the patient underwent 3 mm punch biopsies and subsequently digital amputation of the finger with pathology-proven melanoma. Histopathology investi- gation demonstrated three melanoma in situ and one inva- sive melanoma with a Breslow thickness of 1 mm. Few cases of melanoma arising in burn scars are reported in the literature [2], with a 2005 review by Atzeni et al [3] finding 36 reported cases, 4 of which involved multiple melanoma transformations in a single burns scar. Only one additional case report has been published since then [4]. The mechanism for melanoma formation in a burn scar is not fully known. Burns as a causative agent for malignant transformation could be compared with known melanoma risk factors, which indicate that severe sun- burns of a single area produce greater risk than chronic sun damage [5]. Several studies have suggested a disease mechanism secondary to carcinogenic toxins produced at the site of the burn [6], while others have postulated that burns increase the susceptibility to neoplastic change once a carcinogen is present [7]. This case report highlights the vigilance required from clinicians when performing skin examinations, and the importance of biopsies to newly pig- mented lesions.

References

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