The Koebner phenomenon or the isomorphic response is the development of preexisting skin disease following trauma to uninvolved skin. Various cutaneous disorders have been described to arise at surgical scars. We present a 65-year-old woman with a lentiginous acral melanoma that was excised and reconstructed with a full skin graft.
Ten years after, a local recurrent melanoma that exhibited striking tropism for skin graft is described. The melanoma cells proliferated exclusively within the skin graft. In the literature several cases of primary or recurrent lentigo maligna melanoma that invaded a graft partially have been reported, all of them presenting a clinical pigmentation located essentially on the nontransplanted skin.
To our knowledge, this is the first reported case of recurrent malignant melanoma clinically confined to a surgical skin graft.
CITATION Dermatol Surg. 2006 Jun;32(6):867-70