Abstract Cutaneous melanoacanthoma is a rare benign
epidermal melanocytic lesion. It occurs in the head and
is similar to seborrheic keratosis or pigmented basal cell
carcinoma. It grows slowly and is usually seen in elderly
male patients. It rarely occurs on the back. A 55-year-old
woman presented with a red-colored nodular lesion of
her back. Four years previously it had been noted by the
patient; it was a red colored nodular lesion and 0.5 cm in
diameter at that time. It had enlarged and was now 4 cm
in diameter. Previous biopsies had been diagnosed as
basal cell carcinoma and it was for this reason she was
seen. On physical examination, a painless, crusty,
red–black-colored, mobile lesion, 4 cm in diameter, was
observed. The lesion was totally excised, and repaired
with a Limberg flap. The specimen was sent for histo-
pathological examination, which revealed a diagnosis as
a melanoacanthoma. No recurrence was seen 6 months
later and the postoperative result was cosmetically ac-
Keywords Melanoacanthoma · Scapular area
Mishima and Pinkus stated that cutaneous melanoacan-
thoma is a rare type of pigmented seborrheic keratosis
which shows an increase in the concentration of melano-
cytes . It should be differentiated from other types of
pigmented seborrheic keratosis found in the head and
neck region, or pigmented basal cell carcinoma. It is
more frequently seen in the sixth decade or later, and has
male predominance. Clinically, it progresses slowly .
The lesions rarely occurs on the back . In this case
report, a left scapular melanoacanthoma occurring on the
back is presented.
A 55-year-old woman presented with a lesion on her back; it was a
red colored nodule initially 0.5 cm in diameter, having slowly en-
larged. The diameter was now 4 cm. Previous biopsies were diag-
nosed as basal cell carcinoma.
On examination, the lesion had a well-defined border; it was
painless, crusty, red-black colored, mobile, and 4 cm in diameter.
There was surrounding hyperemia (Fig. 1).
The lesion was totally excised and sent to pathology. The de-
fect was repaired with a Limberg flap. The histology showed tu-
mor lobules containing acanthotic basaloid cells, many melano-
cytes scattered throughout tumor lobules, and linear infiltration of
mononuclear inflammatory cells beneath tumor tissue (Fig. 2 a,b).
Thus it was diagnosed as melanoacanthoma. Six months later,
there was no recurrence and the postoperative result was cosmeti-
cally acceptable (Fig. 3).
I. Askar (
Department of Plastic and Reconstructive Surgery,
Dicle University Medical School, Diyarbakir, Turkey
Department of Pathology, Dicle University Medical School,
Eur J Plast Surg (2002) 24:391–393
I. Askar · H. Buyukbayram
Received: 6 June 2001 / Accepted: 7 November 2001 / Published online: 15 January 2002
© Springer-Verlag 2002
Fig. 1 The clinical appearance was that of a red–black-colored,
painless, mobile, well-delineated lesion, 4 cm in diameter, with