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AAD 2024: Frankincense Application May Impact Melanoma Diagnosis

By: Julia Fiederlein Cipriano, MS
Posted: Friday, March 29, 2024

In a case study, which was presented as a poster during the 2024 American Academy of Dermatology Association (AAD) Annual Meeting (Poster 53121), topically applied frankincense appeared to partially treat a superficial portion of a primary melanoma and confound the histologic diagnosis. Thus, Ashley Elsensohn, MD, MPH, of Loma Linda University, California, and colleagues urged dermatologists to caution patients against the use of this Boswellia resin–derived essential oil in the management of potential cutaneous malignancies.

“Melanoma can persist due to mutations in the prosurvival protein BCL2,” the investigators explained. “Frankincense can reduce BCL2 expression and increase BAX expression, a proapoptotic protein, leading to melanoma regression while sparing normal melanocytes in animal models.”

The case study focused on a 66-year-old woman who presented for a full-body skin exam after having recently been diagnosed with melanoma. The patient previously underwent punch biopsy by an outside provider on the right upper arm for a changing mole; she treated the lesion with frankincense oil daily for 6 months. Outside histology found a lobulated proliferation of dermal melanocytic nests with atypia, which, according to the investigators, stained positively with S100, MELAN-A, and Ki67. No epidermal connection was identified. The histologic findings suggested a diagnosis of metastatic melanoma. Wide local excision of the site revealed focal residual melanoma in situ, with clear margins and two negative sentinel right axillary lymph nodes.

“Dermatologists and pathologists should be aware of [the potential effects of frankincense],” the investigators concluded.

Disclosure: No disclosure information for the study authors was provided.

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