The development of a Marjolin's cancer in a human immunodeficiency virus-positive hemophilic man and review of the literature.
BACKGROUND
The malignant potential of chronic ulcers and scars secondary to a variety of injuries is well characterized in the medical literature. Furthermore, it has been reported that human immunodeficiency virus (HIV)-positive patients have a higher incidence of basal cell carcinoma (BCC) than the general population.


OBJECTIVE
To describe a case of an unusually aggressive morpheaform BCC that developed in a 28-year-old HIV-positive patient. The tumor developed in a scar 25 years after the initial trauma (Marjolin's ulcer).


METHODS
Description of a case and review of the literature of Marjolins ulcer.


RESULTS
The tumor was removed in a seven-stage, 21-section, micrographically controlled excision. Intraoperatively, perineural invasion of the infraorbital nerve was observed. The postoperative defect was repaired using a full-thickness skin graft.


CONCLUSIONS
Although most malignancies arising within chronic scars are SCCs, BCCs and a number of other tumors have been described. Mohs micrographic surgery was effective in treating this aggressive morpheaform BCC. A high degree of suspicion in any changing healed scar is recommended.
Rahimizadeh
A
A
Department of Dermatology, Mount Sinai Medical Center, New York, New York, USA.
Shelton
R
R
Weinberg
H
H
Sadick
N
N
D000328:Adult; D002280:Basal Cell Carcinoma / Q000209:etiology* / Q000601:surgery; D015658:HIV Infections / Q000150:complications*; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D008297:Male; D015580:Mohs Surgery; D017169:Neoplasms, Post-Traumatic / Q000209:etiology; D012878:Skin Neoplasms / Q000209:etiology* / Q000601:surgery