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Marjolin's ulcer: modern analysis of an ancient problem
Mahlon A Kerr-Valentic1, Kian Samimi, Brooks H Rohlen
1Salt Lake City, Utah; and San Diego and Palo Alto, Calif. From the Division of Plastic Surgery, University of Utah Health Science Center, and the Department of Anesthesia, Stanford University School of Medicine.
Background:
Marjolin's ulcer is a rare but highly aggressive squamous cell cancer that is most often associated with chronic burn wounds. Although many individual case reports exist, no thorough evaluation of Marjolin's ulcer patients has been conducted to date.
Methods:
The authors present their experience with 10 patients encountered over a period of 15 years and analyze 25 previous publications, for a total of 443 patients diagnosed with Marjolin's ulcer.
Results:
Although burn scar represents 76.5 percent of patients in the authors' review, venous stasis ulcers, traumatic wounds, osteomyelitis, and pressure sores are also represented as wound types that can undergo malignant degeneration.
Conclusions:
The authors' review suggests that there is much variability in the anatomical location of Marjolin's ulcers, with the majority occurring in wounds of the upper and lower extremities. Marjolin's ulcer appears to be preventable if early wound coverage is undertaken. Countries with limited access to medical treatment report a high number of Marjolin's ulcers compared with more developed regions.
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