[Marjolin's ulcer on burn scar, a curable but neglected disease].
We discuss 9 consecutive carcinomas developed on postburn scars. Our interest was focused on surgery, recurrence, metastasis and long-term survival. The delay between burn trauma and the first clinical manifestation was 25-63 years. The most common localisation was in the limbs (10). Two cases presented with visceral metastasis. We performed either wide excision and grafting (5) or amputation (5). From the anatomo-pathological stand point we encountered 8 SCC and 1 BCC. In 6 cases we had no local recidive or metastasis. One presented a local recidive. There were two deaths--lung metastasis and "spontaneous" rupture of invaded axillary artery. The Marjolin's ulcer has a low incidence because of the patient's poor education. The prophylactic attitude is optimal. We favour early excision--grafting of the deep burns, long-term follow-up, excision and grafting of unstable areas (joint area, depigmented regions, chronic ulcers). The optimal surgical technique is excision followed by skin grafting since it allows early detection of the recurrence.
Pieptu
D
D
Clinica de Chirurgie Plastică şi Reconstructivă, Facultatea de Medicină, Universitatea de Medicina si Farmacie Gr.T. Popa, Iaşi.
Luchian
S
S
Copăceanu
M
M
Popa
M
M
Hriscu
M
M
Stătescu
C
C
D000328:Adult; D000368:Aged; D002056:Burns / Q000150:complications*; D002921:Cicatrix / Q000150:complications* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000209:etiology* / Q000503:physiopathology; D012883:Skin Ulcer / Q000150:complications* / Q000209:etiology; D013997:Time Factors