[Marjolin ulcer; malignant degeneration in a chronic wound]

A chronic ulcerating wound may turn malignant. The term 'Marjolin ulcer' is used to describe any skin malignancy which develops in an area of chronic ulceration, irritation or inflammation. It is generally a squamous cell carcinoma.

A 66-year-old woman was admitted urgently due to pain and signs of infection in wounds on her back which she had had for six to seven years. The patient had sustained wounds to her back as a result of a hot water scalding at the age of two. These wounds had healed and scarred. Pathological examination of three punch biopsies taken from the margins of the largest ulcer indicated a squamous cell carcinoma; a Marjolin ulcer was diagnosed.

If a patient has chronic skin lesions associated with non-healing ulcers, especially after sustaining burn injuries as a child, pathological examination is indicated. This can allow a potential skin malignancy to be identified and treated at as early a stage as possible.