Our Dermatol Online. 2014; 5(4): 429
DOI:. 10.7241/ourd.20144.25
Date of submission: 24.07.2014 / acceptance: 29.08.2014
Conflicts of interest: None
MARJOLIN’S ULCER
Niloofar Mehrolhasani
Department of Dermatology, Kerman Medical University, Iran
Corresponding author: Dr Niloofar Mehrolhasani e-mail: mehrolhasaniniloofar@gmail.com
How to cite this article: Mehrolhasani N. Marjolin’s Ulcer. Our Dermatol Online. 2014; 5(4): 429.
A 45 years old man who had sustained a burn injury to his right hand 20 years ago come to our dermatology clinic with complaint of a rapidly growing fungating mass in burn scar from 4 months ago (Fig. 1). A biopsy of the mass revealed invasive squamous cell carcinoma consistent with Marjolin Ulcer (Fig. 2). The patinet underwent wide local excision and placement of a split thickness skin graft.No evidence of tumor was identified in the sentinel lymph nodes. MU is a rare and aggressive cutaneous malignant transformation with an incidence of 0.1% to 2.5% after a long-term inflammatory or traumatic insult to the skin [1,2]. The main etiology tends to be post-burn scars and traumatic wounds [3]. Since biopsy remains the gold standard for the diagnosis of MU, it should be applied for suspicious lesions that have not healed in 3 months [4]. MU is more aggressive than primary skin tumors, therefore nodal assessment and wide surgical excision are recommended [5]. This potentially fatal complication may be preventable and treatable by surgical management of initial injuries and early diagnosis and treatment of unhealed ulcers [4].
Figure 1. Rapidly growing fungating and necrotic mass in burn scar.
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Figure 2. Haphazardly oriented lobules of atypical keratinocytes with an infiltrative growth pattern within the dermis. Some lobules show formation of squamous pearl.
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