Remember to Consider Malignancy in Patients with Chronic, Nonhealing Wounds

Such wounds should be biopsied periodically for malignant transformation.

Marjolin described malignant degeneration of a burn scar. Since his report in 1828, others have expanded the use of the term Marjolin ulcer to include malignant transformation of skin ulceration or scarring related to a range of conditions (burns, lupus, traumatic wounds, pressure ulcers, pilonidal sinuses, leprosy, and amputation, among others). Most of the cancers have been squamous cell carcinomas. The frequency of this process is not known.

A recent report from an Italian facility that handles difficult wounds details the authors' experience with malignant processes occurring in chronic ulcers. Over a 10-year period, 1000 patients with chronic ulcers were treated at this center. Thirteen patients developed skin cancers (7 squamous cells,…

Reviewing Author

Jeffrey P. Callen, MD

Disclosures

Consultant / Advisory board XOMA; Eli Lilly; Celgene

Equity Various trust accounts

Editorial boards JAMA Dermatology; UpToDate

Leadership positions in professional societies Association of Professors of Dermatology (President-Elect)