title: The development of a Marjolin's cancer in a human immunodeficiency virus-positive hemophilic man and review of the literature.
abstract: 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.
authors.affiliation: Department of Dermatology, Mount Sinai Medical Center, New York, New York, USA.
authors.forename: A
authors.initials: A
authors.lastname: Rahimizadeh
authors.forename: R
authors.initials: R
authors.lastname: Shelton
authors.forename: H
authors.initials: H
authors.lastname: Weinberg
authors.forename: N
authors.initials: N
authors.lastname: Sadick
mesh_terms: 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