COL1A1 and immune system disorder: DFSP was observed to occur in pre-traumatic areas, including vaccination sites, burn scars, tattoos, surgical scars, and radiotherapy.15 Trauma may initiate chronic inflammation that leads to immune system disorder and then malignant transformation of the dermis.15 This hypothesis is supported by genetic findings such as chromosomal translocation of t(17; 22) (q22; q13) between chromosomes 17 and 22, the fusion of gene COL6A3-PDGFD, and the fusion of gene COL1A1-PDGFB.15,17