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Malignancy in chronic leg ulcers

D Yang1, B D Morrison, Y K Vandongen

  • 1Fremantle Hospital, WA. dmulcahy@cyllene.uwa.edu.au

The Medical Journal of Australia
|June 17, 1996
PubMed
Summary
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Malignant ulcers are found in 4.4% of leg ulcer patients. Basal cell carcinoma and squamous cell carcinoma are the most common types, highlighting the need for biopsies in non-healing or suspicious leg ulcers.

Area of Science:

  • Dermatology
  • Oncology
  • Wound Care

Background:

  • Chronic leg ulcers are a common clinical problem.
  • Malignant transformation within chronic leg ulcers is a recognized, albeit infrequent, complication.
  • Early identification of malignant changes is crucial for effective management.

Purpose of the Study:

  • To determine the incidence of malignant ulcers among patients presenting to a specialized leg ulcer clinic.
  • To characterize the types of malignancies found in leg ulcers.

Main Methods:

  • A descriptive study was conducted using data from 981 patients with 2448 leg ulcers treated between July 1988 and June 1995.
  • Tissue biopsies were performed on ulcerated lesions suspicious for malignancy or unresponsive to treatment.
  • Data on patient demographics, ulcer characteristics, and histopathological findings were analyzed.

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Main Results:

  • Out of 981 patients, 43 (4.4%) had malignant lesions on their legs.
  • The frequency of malignant ulcers was 2.2 per 100 leg ulcers.
  • Basal cell carcinoma accounted for 75% of malignant ulcers, and squamous cell carcinoma for 25%.

Conclusions:

  • Malignant skin changes are a significant concern in chronic leg ulcers.
  • Biopsy is recommended for all suspicious leg ulcers or those failing to respond to standard treatment.
  • Increased awareness and diagnostic vigilance are necessary for clinicians managing leg ulcer patients.