[Post-traumatic acral melanoma: an underestimated reality?]

Area of Science:

• Oncology
• Dermatology
• Pathophysiology

Background:

• The link between trauma and malignant melanoma development is debated.
• Previous studies suggest trauma may influence tumor progression, but evidence for melanoma is controversial.
• This study investigates a case of acral melanoma potentially linked to trauma and reviews relevant literature.

Observation:

• A 73-year-old male presented with a lesion on his right big toe.
• The lesion was identified as an ulcerated superficial spreading melanoma with a Breslow thickness of 4mm.
• The patient had a history of significant trauma to the same toe, including a fracture and subsequent injuries leading to nail dystrophy.

Findings:

• The case demonstrated a clear temporal and topographical association between trauma, nail dystrophy, and melanoma development.
• Literature review indicates trauma is an independent risk factor for acral melanoma.
• Repeated trauma appears to significantly elevate the risk, suggesting a dose-effect relationship.

Implications:

• Trauma may act as a promotional factor in acral melanoma development, possibly through cytokine release or direct tumor cell transport.
• Dermatologists should be vigilant regarding changes in old scars or previously injured sites.
• This supports the hypothesis that trauma can contribute to the pathogenesis of acral melanoma.