Marjolin's ulcer
4411743
207706747
2008-04-23T21:46:09Z
GregorB
179697
/* Appearance */ Fmt
[[Image:Marjolin ulcer.JPG|thumb|right|250px|'''Marjolin's ulcer''' presenting on arm following a burn]]
'''Marjolin's ulcer''' refers to an aggressive [[ulcer|ulcerating]] [[squamous cell carcinoma]] presenting in an area of previously [[Physical trauma|traumatised]] <ref> Esther RJ, Lamps L, Schwartz HS. Marjolin ulcers: secondary carcinomas in chronic wounds. J South Orthop Assoc. 1999 Fall;8(3):181-7.</ref>, chronically inflamed <ref>Simmons MA, Edwards JM, Nigam A. Marjolin's ulcer presenting in the neck. J Laryngol Otol. 2000 Dec;114(12):980-2.</ref>, or scarred skin <ref> Phillips TJ, Salman SM, Bhawan J, Rogers GS. Burn scar carcinoma. Diagnosis and management. Dermatol Surg. 1998 May;24(5):561-5. </ref>. They are commonly present in the context of [[chronic (medicine)|chronic]] [[wound]]s including [[Burn (injury)|burn injuries]], [[venous ulcer]]s, ulcers from [[osteomyelitis]] <ref>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.</ref>, and post [[Radiotherapy#Acute side effects|radiotherapy]] scars.
The term was named after [[France|French]] [[surgeon]], [[Jean Nicolas Marjolin]], who first described the condition in 1828. The term was later coined by [[J C De Costa]].
==Appearance==
Maslow growth, painlessness (as the ulcer is usually not associated with [[nerve]] tissue), and absence of [[lymph]]atic spread due to local destruction of lymphatic channels<ref>Paredes F. Marjolin ulcer. Acta Med Port. 1998 Feb;11(2):185-7.</ref>.
==Characteristics==
[[Histology|Histologically]], the tumour is a well-[[Grading (tumors)|differentiated]] squamous cell carcinoma. This carcinoma is aggressive in nature, spreads locally and is associated with a poor [[prognosis]]<ref>Chong AJ and MB Klein. Marjolin's ulcer. New England Journal of Medicine 2005 Mar; 352(1):e9</ref>.
==Diagnosis==
[[Biopsy]] is favored method of diagnosis. [[Biological tissue|Tissue]] specimens obtained should be taken from both the centre and margin of [[lesion]], as the central ulcerated deposits may be [[necrosis|necrotic]].
==Treatment==
Treatment is usually surgical, with a wide [[excision]] of the [[lesion]]; typically a 1 [[Metre|cm]] margin all around is required.
==References==
<references />
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[[Category:Dermatology]]