[Post-traumatic acral melanoma: an underestimated reality?]. / Mélanome acral post-traumatique : une réalité sous-estimée ?
Ann Dermatol Venereol
; 139(11): 727-31, 2012 Nov.
Article
em Fr
| MEDLINE
| ID: mdl-23199769
ABSTRACT
BACKGROUND:
The role of trauma in the physiopathology of malignant melanoma remains controversial. We report a case of acral melanoma in which a characterized trauma seems implicated in tumour progression; we performed a review of the literature. PATIENTS ANDMETHODS:
A 73-year-old male consulted for a lesion of his right big toe. Physical examination revealed a dystrophic and hyperkeratotic nail destroyed by a growing lesion. Histological study showed an ulcerated superficial spreading melanoma with a Breslow thickness of 4mm. He had previously had this same toe broken, leaving gradually worsening dystrophy of the nail; the toe was injured again spontaneously and by partial removal of the nail tablet.DISCUSSION:
A number of cases of "post-traumatic" melanomas have been reported. This hypothesis, though widely admitted for other tumours, remains debated for melanomas mainly because of possible recall bias. In this patient, there was a clear continuum of the lesion as well as topographic correspondence between the initial trauma, the remaining dystrophy and the appearance of the melanoma. Case-control studies have identified trauma as an independent risk factor for acral melanoma with a high relative risk; such risk is multiplied for repeated trauma, suggesting a "dose-effect" relationship. Trauma could act as the promotional stage of melanoma mediated by cytokines released during wound healing or it could cause direct activation of micro-vascular tumour cell transport.CONCLUSION:
Our observation and literature research provide convincing arguments for a role of trauma in the development of acral melanomas. Dermatologists must pay attention to any unusual changes in an old scar.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Cutâneas
/
Dedos do Pé
/
Neoplasias Pós-Traumáticas
/
Traumatismos do Pé
/
Fraturas Ósseas
/
Melanoma
/
Doenças da Unha
/
Unhas
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Humans
/
Male
Idioma:
Fr
Revista:
Ann Dermatol Venereol
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
França
País de publicação:
FR
/
FRANCE
/
FRANCIA
/
FRANÇA