Carcinomatous degeneration of chronic scars, known as Marjolin's ulcer, are relatively rare. The majority of them are squamous cell carcinoma or other skin cancers including basal cell carcinoma. But malignant melanoma, especially amelanotic
melanoma,
developing from a chronic burn scar is extremely rare.
We have experienced a case of amelanotic melanoma arsing from a chronic burn scar in a patient, 53-year-old female, who had a painful erythematous ulcerated nodule onthe left heel for about 20 years since she had sustained a burn there at the age
of 1
year. Although there are no melanin pigments in hematoxylin-eosin (H & E) stain as well as in Fontana-Masson stain, a biopsy specimen from the skin lesion revealed cytologic atypia and junctional activity in the dermoepidermal junction and
positive
immunohistochemical staining for S-100 protein, which is consistent with amelanotic melanoma.
The lesion was widely excised and a skin graft was done. She was also treated with intralesional BCG injection and recurrence or metastasis was not detected during the follow up period of 6 months.(Kor J Dermatol 1995;33(2) : 339-343)
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