Synchronous appearance of keratoacanthomas in burn scar and skin graft donor site shortly after injury

Tamir, Gabriel; Morgenstern, Sara; Ben-Amitay, D; Okon, E; Hauben, Daniel J.

doi:10.1053/jd.1999.v40.a94419

Cited by 27 publications

(13 citation statements)

References 11 publications

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“…9 Malignant fibrous histiocytoma, malignant melanoma, liposarcoma, fibrosarcoma, eccrine syringofibroadenoma, neuroendocrine (Merkel cell) carcinoma, and keratoacanthoma have also been reported in the literature. [33][34][35] Bernstein et al defined Marjolin's ulcer as a variant of squamous cell carcinoma in their study. Ten common variants of squamous cell carcinoma presented in their article were neurotrophic squamous cell carcinoma, Bowen's disease, squamous cell carcinoma in transplant patients, keratoacanthomalike squamous cell carcinoma, squamous cell carcinoma of the lip, adenoid squamous cell carcinoma, spindle cell squamous cell carcinoma, radiation-induced squamous cell carcinoma, verrucous carcinoma, and Marjolin's ulcer.…”

Section: Plastic and Reconstructive Surgery • July 2009mentioning

confidence: 99%

Marjolin’s Ulcer: A Preventable Complication of Burns?

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2009

Plastic and Reconstructive Surgery

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Marjolin's ulcer is a rare and aggressive cutaneous malignancy that arises on previously traumatized and chronically inflamed skin, especially after burns. This clinical condition was first described by Marjolin in 1828. The term "Marjolin's ulcer" has been generally accepted to refer to a long-term malignant complication of the scars resulting from burns. However, vaccination, snake bites, osteomyelitis, pilonidal abscesses, pressure sores, and venous stasis may also induce this tumor. Clinically, reports suggest that atrophic and unstable scars tend to develop into cancer. Various etiological factors have been implicated in the condition, including toxins released from damaged tissues, immunologic factors, cocarcinogens, and miscellaneous factors such as irritation, poor lymphatic regeneration, antibodies, mutations, and local toxins. The incidence of burn scars undergoing malignant transformation has been reported to be 0.77 to 2 percent. All parts of the body can be affected, but the extremities and the scalp are most frequently affected. There are two variants: acute and chronic. In the former, the carcinoma occurs within 1 year of the injury. The chronic form is more frequent and malignancy tends to develop slowly, with an average time to malignant transformation of 35 years. Although many different cell types can be seen in these lesions, the major histological type is squamous cell carcinoma. Marjolin's ulcers are generally considered as very aggressive tumors with a higher rate of regional metastases; radical excision is the treatment of choice, but there is no consensus on lymph node dissection. Marjolin's ulcer can be insidious and often leads to a poor prognosis, and deaths from Marjolin's ulcer are not uncommon. Meticulous wound care is a crucial step in prevention of these lesions.

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Section: Plastic and Reconstructive Surgery • July 2009mentioning

confidence: 99%

Marjolin’s Ulcer: A Preventable Complication of Burns?

Copçu

2009

Plastic and Reconstructive Surgery

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“…Considering the initial histology in this case had features of KA we included four further cases of reported KA in donor sites. 4,5 In total one case of SCC and one case of KA had developed following split thickness skin graft harvest to cover the defect following excision of a melanoma. The mean time for development of SCC was 6.6 months versus 7.3 weeks in reported cases of KA, comparable with our patient's six week interval.…”

Section: Discussionmentioning

confidence: 99%

Squamous cell carcinoma arising in a skin graft donor site following melanoma extirpation at a distant site: A case report and review of the literature

et al. 2015

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s u m m a r yThe development of both squamous cell carcinoma (SCC) and keratoacanthoma (KA) in donor sites following split thickness skin graft harvest are rare complications reported in the literature. Management of such cases requires a precise distinction between keratoacanthoma and SCC and knowledge of the degree of differentiation. We describe the case of a 48-year-old male who developed a squamous cell carcinoma with features of KA within a donor site on his right thigh. This developed six weeks following split skin graft harvest to cover a defect on his right anterior chest following wide local excision of a 2.4 mm Breslow thickness superficial spreading melanoma. We review previous cases in the literature along with theories suggested for their development and conclude the development of SCC with features of KA in this reported case was likely a de novo lesion. This case highlights the need for evaluation of the donor site at all surveillance examinations of the primary tumor site and urgent diagnostic biopsy of all non-healing and new lesions.

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“…Therefore, most "recurrences" of KA are considered to represent a reactive process in the proliferation phase rather than neoplastic changes or remnants of the neoplastic cells (5,12,13). In fact, the development of KAs has been reported to occur at sites of various types of trauma, including thorn injuries, dog scratches, tattoos and burn scars (10,14,15).…”

Section: Discussionmentioning

confidence: 99%