title: Marjolin's ulcer: a rare entity with a call for early diagnosis.
abstract: Marjolin's ulcer (MU) is an umbrella term covering squamous cell carcinoma (SCC), basal cell carcinoma and malignant melanoma that develop in chronic wounds, sinuses or scars. Cutaneous (non-MU) SCC is related to excessive sun-exposure, with Fitzpatrick skin types I and II being more susceptible. Radiation, genetic disorders (eg, Xeroderma pigmentosum) and immunosuppression, are other important risk factors often involved in the development of cutaneous malignancies and may also be involved in the development of MU. MU, first described by Jean-Nicholas Marjolin in 1828, is more aggressive than non-MU SCC, with a higher potential for early metastasis. A high index of suspicion and early histological diagnosis in chronic wounds and unstable scars with recent changes in characteristics offer the best prognosis with treatment. We present a case alongside a literature review contrasting the characteristics of MU and non-MU SCC, and suggest a management plan for early MU identification and prevention.
authors.affiliation: Department of Medicine, Keele University, Newcastle under Lyme, UK.
authors.forename: Fahad Mujtaba
authors.identifier: http://orcid.org/0000-0003-0834-1275
authors.initials: FM
authors.lastname: Iqbal
authors.affiliation: Keele, Stoke-on-Trent, UK.
authors.forename: Yashashwi
authors.initials: Y
authors.lastname: Sinha
authors.affiliation: Department of Plastic Surgery, University Hospital of North Staffordshire, Stoke-on-Trent, UK.
authors.forename: Wayne
authors.initials: W
authors.lastname: Jaffe
mesh_terms: D000368:Aged; D001365:Axilla; D002056:Burns / Q000150:complications*; D002294:Carcinoma, Squamous Cell / Q000209:etiology / Q000473:pathology*; D003286:Contracture / Q000150:complications*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D012867:Skin; D012878:Skin Neoplasms / Q000209:etiology / Q000473:pathology*; D012883:Skin Ulcer / Q000209:etiology / Q000473:pathology*