title: Neoplastic transformation of chronic ulcers in leprosy patients--a retrospective study of 23 consecutive cases.
abstract: A retrospective analysis of chronic ulcers among leprosy patients seen over the last 20 years yielded 23 cases of neoplastic transformation. It showed a peak at the sixth decade, an incidence of 3.66/100 among hospitalised ulcer cases and male/female ratio of 1.6:1. Borderline tuberculoid was the most common type of leprosy involved (40%). Squamous cell carcinoma was the most common neoplasia. Its usual site was plantar ulcers. Heel ulcers showed relatively greater predeliction for malignancy (38.5%). Histopathological proof of malignancy is desirable and that may require multiple biopsies. Metastasis is rare but potentially fatal. The surgical treatment must provide a functional, trouble-free limb. Forefoot or Lisfranc's amputation for distal third ulcers and below-knee amputation for large midfoot and ulcers are procedures of choice. Wide excision may be used in select cases.
authors.affiliation: Leprosy Relief Rural Centre, Chettipatty, Salem.
authors.forename: S
authors.initials: S
authors.lastname: Kumaravel
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D002471:Cell Transformation, Neoplastic; D002908:Chronic Disease; D005260:Female; D016523:Foot Ulcer / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D006801:Humans; D015994:Incidence; D007918:Leprosy / Q000150:complications*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012008:Recurrence; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery