Marjolin Ulcer

Excerpt

A Marjolin ulcer, named after French surgeon Jean Nioclas Marjolin, historically referred to a squamous cell carcinoma within a burn scar, but the definition evolved to incorporate all skin malignancies arising within damaged tissue. Squamous cell carcinoma remains the most common malignancy, but many cutaneous cancer types have been identified in inflamed or injured tissue, including trauma, osteomyelitis, and chronic ulcers. Most common sites of marjolin ulcer, in order of decreasing frequency, include the lower extremities, head and neck, upper extremity and trunk, with rare occurrences on the face, foot and digits. Marjolin lesions are aggressive, have a poor prognosis compared to their non-Marjolin counterparts, and have a high recurrence rate. Marjolin ulcers can occur many years, even decades, following the initial injury. A subset of Marjolin ulcers appears within months of initial injury and is termed "acute," often having basal cell histology. Prevention with proper burn wound management, routine surveillance, and early recognition of malignant conversion are critical to reducing morbidity and mortality.