Basal cell carcinoma mimicking a chronic unstable scar in an adolescent patient with Kindler syndrome |
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Authors: | Adrian Dragu Giulio Ingianni M Megahed C Can Cedidi |
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Institution: | 1.Department of Plastic and Hand Surgery, Aesthetic and Reconstructive Surgery,Helios University Clinic Wuppertal, University Clinic Witten/Herdecke,Witten,Germany;2.Department for Dermatology,RWTH University,Aachen,Germany;3.Department of Plastic, Reconstructive and Aesthetic Surgery, Klinikum Bremen-Mitte,Akademisches Lehrkrankenhaus der Universit?t G?ttingen,Bremen,Germany |
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Abstract: | We present the case of Kindler syndrome in a 17-year-old man. After excision, histomorphological analysis, and wound closure
of a chronic unstable scar in the right popliteal region, a basal cell carcinoma was diagnosed accidentally. A malignancy
was not suspected, although the patient already had biopsies, multiple trials of debridement, and skin grafting earlier elsewhere.
While an initial attempt to close the defect with a microsurgical flap was abandoned, due to microvascular irregularities,
a wound closure was achieved with a free skin graft. The postoperative histomorphologic analysis revealed the surprising diagnosis
of a basal cell carcinoma, fortunately with free margins. At follow-up 1 year later, the grafted area was stable, and there
was no recurrent disease. A preoperative histomorphologic analysis of the complete excised chronic wound, especially in known
skin disorders—regardless of young age—is mandatory. Furthermore, the presented case showed that an abnormal deposition of
collagen, and enhanced coprostasis with migration of granulocytes, destroys the normal consistency of small vessels and presents
a limitation for microsurgical procedures in these patients. |
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Keywords: | Kindler syndrome Chronic unstable scar Basal cell carcinoma |
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