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Marjolin's ulcer
1Burn Centre, Charles University Hospital Královské Vinohrady, Prague, Czech Republic. burnsec@fnkv.cz
Acta Chirurgiae Plasticae
|November 4, 2000
Summary
Marjolin's ulcer, a malignant degeneration in burn scars, typically presents after a 30-year latent period. Early detection and treatment are crucial for managing this rare but aggressive squamous cell carcinoma.
Area of Science:
- Dermatology
- Oncology
- Pathology
Background:
- Marjolin's ulcer, characterized by malignant degeneration in burn scars, was first described in 1828.
- This condition has a significant latent period, averaging 30 years, and presents in various clinical settings.
- It typically manifests as a shallow ulcer or exophytic tumor, predominantly on the lower extremities.
Observation:
- The Prague Burn Centre treated 11 patients with Marjolin's ulcer between 1978 and 1998.
- A unique case involved a patient with congenital epidermolysis bullosa who developed Marjolin's ulcer on the foot.
- Histological examination confirmed well-differentiated squamous cell carcinoma in this patient.
Findings:
- The patient with epidermolysis bullosa experienced cachexia and metastatic spread of the tumor.
- The patient's refusal of amputation and lymph node dissection contributed to the advanced disease.
- This case highlights the aggressive nature of Marjolin's ulcer, particularly in immunocompromised or genetically predisposed individuals.
Implications:
- Preventive measures and early diagnostic strategies for Marjolin's ulcer are essential.
- Understanding the risk factors and clinical presentation aids in timely intervention.
- Management requires a multidisciplinary approach, potentially including surgical intervention and oncological treatment.