Atypical fibroxanthoma on a burn scar concomitant with solar elastosis

A 76-year-old man presented with an erythema on the right forehead, where he had suffered a thermal burn at the age of 3 years. The erythema was removed with a 4-mm margin under local anesthesia. A histopathological examination revealed a proliferation of atypical fusiform cells in the upper- to mid-dermis. Aberrant mitoses were also seen. Immunohistochemistry confirmed a diagnosis of atypical fibroxanthoma. Solar elastosis was noted on the overlying basal layer. Atypical fibroxanthoma, as well as squamous cell carcinoma and basal cell carcinoma, may develop on a burn scar. In the present case, sun exposure may be involved in the pathogenesis of atypical fibroxanthoma.