Marjolin's ulcer

From Wikipedia, the free encyclopedia

Marjolin's ulcer refers to an aggressive ulcerating squamous cell carcinoma presenting in an area of previously traumatised ^[1], chronically inflamed ^[2], or scarred skin ^[3]. They are commonly present in the context of chronic wounds including burn injuries, venous ulcers, ulcers from osteomyelitis ^[4], and post radiotherapy scars.

The term was named after French surgeon, Jean Nicolas Marjolin, who first described the condition in 1828. The term was later coined by J C De Costa.

Contents 1 Appearance 2 Characteristics 3 Diagnosis 4 Treatment 5 References

[edit] Appearance

Maslow growth, painlessness (as the ulcer is usually not associated with nerve tissue), and absence of lymphatic spread due to local destruction of lymphatic channels^[5].

[edit] Characteristics

Histologically, the tumour is a well-differentiated squamous cell carcinoma. This carcinoma is aggressive in nature, spreads locally and is associated with a poor prognosis^[6].

[edit] Diagnosis

Biopsy is favored method of diagnosis. Tissue specimens obtained should be taken from both the centre and margin of lesion, as the central ulcerated deposits may be necrotic.

[edit] Treatment

Treatment is usually surgical, with a wide excision of the lesion; typically a 1 cm margin all around is required.

[edit] References

1. ^ Esther RJ, Lamps L, Schwartz HS. Marjolin ulcers: secondary carcinomas in chronic wounds. J South Orthop Assoc. 1999 Fall;8(3):181-7.
2. ^ Simmons MA, Edwards JM, Nigam A. Marjolin's ulcer presenting in the neck. J Laryngol Otol. 2000 Dec;114(12):980-2.
3. ^ Phillips TJ, Salman SM, Bhawan J, Rogers GS. Burn scar carcinoma. Diagnosis and management. Dermatol Surg. 1998 May;24(5):561-5.
4. ^ Smidt LS, Smidt LF, Chedid MB, Bavaresco CS, Chedid MF. Radical surgical treatment for Marjolin ulcer occurring after chronic osteomyelitis South Med J. 2005 Oct;98(10):1053.
5. ^ Paredes F. Marjolin ulcer. Acta Med Port. 1998 Feb;11(2):185-7.
6. ^ Chong AJ and MB Klein. Marjolin's ulcer. New England Journal of Medicine 2005 Mar; 352(1):e9