Marjolin's ulcer and chronic burn scarring

Abstract

Marjolin's ulcer is a term used to describe squamous cell carcinomas which develop in chronic wounds. These carcinomas may also develop at the site of long-standing irritation, such as unstable burn scars. Development times for burn scar carcinomas of more than 30 years have been noted. This evaluation describes the treatment of 10 patients with burn scar carcinomas who have been treated using wide excision and closure of the defect with skin grafts or flaps, plus regional lymph node dissection if required. Results indicate a mean carcinoma development time of 26 years. Local recurrence occurred in only one patient.

The Use of Dermal Substitutes in Burn Surgery: Acute Phase

“…They may also lead to the formation of carcinoma e.g. Marjolin's ulcer (10). These patients with keloids or also suffer from impairment of their quality of life, causing physical, psychological, and social sequelae (11).…”

“…Furthermore, this product has also been used for chronic non-healing wounds and for reconstruction of cutaneous lesions, even with bone exposure, and to fill in soft-tissue defects in reconstructive and aesthetic surgery (31)(32)(33)(34). This dermal substitute was introduced in 1981 by Yannas and Burke (14,35,36), and has been approved by the FDA for use in burns and for unstable scar replacement (10,36).…”

“…The bilayer has an outer layer or membrane composed of silicone (synthetic polysiloxane polymer or silastic) (38), which works as a temporary epidermis and serves to control moisture loss from the wound (10,37,39). In fact, water flux across this silicone membrane is the same as that across normal epidermis, 0.5 ml/cm 2 /hr (40).…”

Bioartificial Skin

“…Scars, however, impose several problems clinically: they are both esthetically and functionally unacceptable due to resulting contractures, they produce chronically unstable wound surfaces and may lead to the formation of scar carcinoma like Marjolin's ulcer [Akguner et al, 1998]. Therefore, the loss of the dermis in extensive full thickness wounds like burns poses a serious problem which is not completely solved by the application of split-thickness autograft skin due to a lack of dermal components.…”

Multiple melanoma arising on a burn scar and extensive sunburn: a case report and a review of the literature

“…Cancers of various sorts are encountered in these cases. Most of these are squamous-cell carcinoma and they are referred to as Marjolin ulcer [1][2][3][4][5][6]. More occasionally, they are basalcell carcinoma.…”