title: Malignant change in chronic irritation: a case series.
abstract: BACKGROUND
  Chronic irritation is a known cause of malignant change in humans. It is believed that at least a minimum of five years is needed for the evolution of the illness.
  
  
  OBJECTIVE
  To present cases of consecutive squamous cell malignant change in patients with various irritations, and to highlight that these cases are not too uncommon in our environment.
  
  
  METHODS
  Case reports of patients with definitive treatments offered. Patients had amputation done after incisional biopsies were done to determine the mitotic status of the lesions.
  
  
  RESULTS
  The three patients presented late. All had lower limb affectation. Conservatism was difficult, all of them ending up with amputation of the affected limbs. One of them had inguinal lymph node metastasis after the amputation, signifying advanced disease, but unfortunately had to leave hospital because she could not cope with the financial demands of treatment.
  
  
  CONCLUSIONS
  Malignant change from chronic irritations can occur under five years. Education might help early presentation and improved outcome. Our hospitals should provide for the treatment of these group of patients despite their financial status.
authors.affiliation: Department of Surgery, College of Health Sciences,University of Port Harcourt, Nigeria.
authors.forename: A U
authors.initials: AU
authors.lastname: Ekere
authors.forename: V U
authors.initials: VU
authors.lastname: Adiela
authors.forename: B M
authors.initials: BM
authors.lastname: Kejeh
mesh_terms: D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical; D001706:Biopsy; D002471:Cell Transformation, Neoplastic; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D005545:Forefoot, Human; D006801:Humans; D007249:Inflammation; D007717:Knee; D007866:Leg; D008297:Male; D008875:Middle Aged; D018307:Neoplasms, Squamous Cell / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D013978:Tibial Fractures / Q000150:complications* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D014456:Ulcer / Q000150:complications* / Q000473:pathology / Q000601:surgery; D014945:Wound Healing