Marjolin’s ulcer A case series

Abstract

Background: Marjolin’s ulcer (MU) is a rare but aggressive malignant transformation of long-standing scars or chronic wounds.

Case Illustration: we present three cases of MU that arise from post-traumatic scar. Two of the cases were found on the lower extremity and one on the scalp. Two lesions of lower extremities were preceded by burn injury from various causes. One lesion on the scalp was caused by non-burn trauma. Diagnosis was confirmed after tissue biopsy which revealed well-differentiated squamous cell carcinomas. Two patients underwent surgical intervention (wide excision and Mohs micrographic surgery) followed by split-thickness skin graft (STSG). In one patient, a wide excision was planned to be performed but the patient died before the surgery.

Discussion: the most frequent type of MU is squamous cell carcinoma (SCC). Extremity is the most common sites of predilection followed by the head and neck region. Marjolin’s ulcer with histopathological features of SCC is more aggressive and carries a poor prognosis with a high rate of recurrence.

Conclusion: early recognition of malignant conversion followed by comprehensive staging and early treatment, are of the utmost importance. Surgery remains the optimal treatment for MU, frequent and intense follow-up after surgery is required.