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August 1996

Possible Neural Basis for the Field Effect in Local Recurrence of Melanoma In Situ

Author Affiliations

Rochester General Hospital 1425 Portland Ave Rochester, NY 14621

Arch Dermatol. 1996;132(8):971-972. doi:10.1001/archderm.1996.03890320121022

I read with interest the case report by Husain et al1 on melanoma in situ of the sole of the foot that extended into an adjacent skin graft. They observed that the lesion "maintained a morphologic pattern of the acral lentiginous type," even when interacting with keratinocytes of a skin graft that still manifested a grointype pattern of epidermal growth. This was an interesting and instructive "experiment of nature."

A second aspect of the authors' case is also an interesting experiment of nature. They noted that the 77-year-old black man's recurrent melanoma in situ on the heel (10 years after the original wide excision with fullthickness skin graft) extended "from the smooth indigenous skin on the sole into the grafted skin." It appears that the field effect responsible for this recurrence originated in the indigenous skin rather than in the grafted skin. This restriction of recurrence to indigenous

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