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Case Study
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MarjolinÕs ulcer: report of two cases Moises Menendez, MD, FACS, CWS, Robert A. Warriner, III MD, FCCP, FACA, ABPM/UHM, CWS, Wound Healing Center, El Dorado, AR MarjolinÕs ulcer is an epidermoid carcinoma arising in chronic ulcers, or burn scars. This condition is most commonly seen after post burn scars as originally described by Jean Nicholas Marjolin in the eighteen century. However, it could originate from other chronic wounds of long duration. This malignancy could have two forms: an acute form in which the malignant process occurs within a year of injury, and a chronic variant in which the injury precedes the malignant change by decades. We present two cases where these two variants take place. In the second case, because of the location of the lesion, the use of the Sentinel Node Biopsy technique was very appropriate. We also encourage the liberal use of biopsies in long standing chronic ulcers, and repeated biopsies if necessary, as was done in the first case. Thio D, Clarkson JHW, Misra A, Srivastava S. Malignant change alter 18 months in a lower limb ulcer: acute Marjolin's ulcer revisited. Br Association Plast Surg. 2003;56:825Ð828 Sabin SR, Goldstein G, Rosenthal H, Haynes K. Aggressive squamous cell carcinoma originating as a MarjolinÕs ulcer. Dermatol Surg. 2004;30(2):229 Hill B, Sloan D, Lee E, McGrath P, Kenady D. MarjolinÕs ulcer of the foot caused by nonburn trauma. SMJ. 1996 Lawrence WT. Clinical management of nonhealing wounds. In: Cohen IK, Diegelmann RF (eds). Lindblad WJ. Wound Healing. Philadelphia, Pa: WB Saunders Co, 1992:541Ð546 Lauvin R, Miglianico L. Skin cancer occurring 10 years after the extravasation of doxorubicin. N Eng J Med. 1995;11(332):754 Christopher JW, Li BD, Gonzalez E, Valiulis JP, Cunningham M, McCulloch J. Nonhealing ulcer in a diabetic foot. WOUNDS. 2004;16(6):212Ð217 Snyder R. The importance of biopsy in wound management: lesion biopsy should be an essential part of the wound healing algorithm: wound care and diabetes Q&A. Podiatry Manage. March 2003 Dupree MT, Boyer JD, Cobb MW. MarjolinÕs ulcer arising in a burn scar. Cutis.1998;62(1):49Ð51 Trent J, Kirsner R. Wounds and malignancy. Adv Skin Wound Care. 2003;16(1):31Ð34 Rakel: ConnÕs Current Therapy. 2004, 56th ed. . |
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