This study aims to report a case of a 48 year old male patient with melanoma and multiple basal cell carcinomas diagnosed by biopsy. The patient was admitted at a Dermatology Service in February 2022, referred from another service, in which it was suspected skin picking and melanoma. At the time of the primor consult, it was observed on examination diffuse infiltrated ulcerated lesions, with raised borders with the biggest one (right calf) measuring approximately 10cm in the largest diameter and a melanocytic macule measuring 3x2 cm on the left arm. He also presented horizontal nystagmus, which was as well found on his brother who was accompanying the patient. He additionally had a history of schizophrenia and diabetes in use of haloperidol, risperidone, sertraline, biperiden and insulin. Four biopsies were done: an excisional of the melanocytic macule, and three incisionals of the ulcerated lesions with major risk at the time (right calf, right hand and right arm) and he was also referred to an ophthalmologist. On histopathological study the first lesion was compatible with melanoma in situ and the two others with nodular basal cell carcinoma. The ophthalmologic evaluation showed congenital nystagmus and misrouting of the left eye, as well as cataract in both eyes, leading to a difficult evaluation of the eye fundus, with no compatibility with syndromic diagnosis. The patient was referred to a specialized oncology center for specific treatment. We aim to report this case since the patient has diverse massive oncologic lesions, even though oculocutaneous albinism, neither other syndromes, could be confirmed. Genetic study will need to be performed.

Skin cancer, which includes melanoma and non-melanoma skin cancer, represents the most common form of malignancy. This study aims to report a case of a 48 year old male patient with melanoma and multiple basal cell carcinomas diagnosed by biopsy. The patient was admitted at a Dermatology Service in February 2022, referred from another service, in which it was suspected skin picking and melanoma. At the time of the primor consult, it was observed on examination diffuse infiltrated ulcerated lesions, with raised borders with the biggest one (right calf) measuring approximately 10cm in the largest diameter and a melanocytic macule measuring 3x2 cm on the left arm. He also presented horizontal nystagmus, which was as well found on his brother who was accompanying the patient. He additionally had a history of schizophrenia and diabetes in use of haloperidol, risperidone, sertraline, biperiden and insulin. Four biopsies were done: an excisional of the melanocytic macule, and three incisionals of the ulcerated lesions with major risk at the time (right calf, right hand and right arm) and he was also referred to an ophthalmologist. On histopathological study the first lesion was compatible with melanoma in situ and the two others with nodular basal cell carcinoma. The ophthalmologic evaluation showed congenital nystagmus and misrouting of the left eye, as well as cataract in both eyes, leading to a difficult evaluation of the eye fundus, with no compatibility with syndromic diagnosis. The patient was referred to a specialized oncology center for specific treatment. The main risk factor associated with the genesis of skin cancers is exposure to ultraviolet radiation. Also, there are many syndromes related such as Gorlyn-Goltz syndrome, xeroderma pigmentosum, Rombo syndrome, Basex syndrome, and oculocutaneous albinism. Immunosuppression and some physical characteristics as light skin and eyes can also be predisposing factors. Although our major hypothesis to the case above was oculocutaneous albinism, neither this pathology or any other cited could be confirmed, once the phenotypic characteristics presented in all syndromes could not be identified in our patient. Also, it's well known that, individuals with albinism have increased risks for non-melanoma skin cancers, otherwise melanomas occurring in the setting of albinism are rare, which occurs in our patient. The history of using photosensitive drugs such as antipsychotics and antidepressants due to the diagnosis of schizophrenia cannot be ruled out as a risk fator, although is less probable. In this case, melanoma was well treated with excisional surgery, and despite the fact that BCC normally behaves like a benign tumor, exceptional cases like the one described need systemic therapy such as Vismodegib, the reason why the patient was referred to a specialized oncology center. We aim to report this case since the patient has diverse massive oncologic lesions, even though oculocutaneous albinism, neither other syndromes, could be confirmed. Genetic study will need to be performed.

ESDR507 - Diagnosis of melanoma and multiples basal cell carcinomas in a 48 year old patient: a case report

The scientific meeting of the European Society for Dermatological Research (ESDR) is held yearly, usually in September. With an international attendance of more than 1000 skin scientists from around the globe, the four-day event includes short oral presentations from peer-reviewed abstracts, keynote lectures from international experts, sponsored symposia, satellite programs, educational events as well as an important focus on posters, networking and building collaborations amongst scientists. For more information about this year’s meeting visit our website.