Abstract:

Ear numbness is a complication of superficial parotidectomy from damage to the great auricular nerve. We report a case of probable self-inflicted burn injury of the helix post superficial parotidectomy, involving an incidental melanocytic nevus. An 82-year-old woman presented for follow up one-month post right superficial parotidectomy with right ear numbness and a newly discovered lesion on the right inferior helix. The lesion was biopsied due to clinical concern for basal cell carcinoma. The biopsy showed full-thickness epidermal and superficial adnexal epithelial necrosis consistent with a burn injury. There was also a cytologically atypical nested dermal melanocytic proliferation. There was no mitotic activity, the silhouette appeared banal, Melan A was positive, HMB-45 was negative, p16 expression was predominantly retained and the MIB-1 proliferation index was less than 1%. Overall findings appeared consistent with a benign intradermal melanocytic nevus showing burn-induced cytologic atypia. The patient had not reported a history of trauma or burn but on questioning did reveal that she curled her hair weekly. It was postulated that while curling her hair, she inadvertently burned the skin on her ear over the prominence of an intradermal melanocytic nevus but was unaware due to postoperative ear numbness. We report this case because of its unique presentation and to highlight that cellular changes can occur with burn injury to benign melanocytic nevi.

Financial Disclosure:
No current or relevant financial relationships exist.

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Mohamed Alhamar, MD