Thirty-one cases of Marjolin's ulcer

Copçu, Eray; Aktaş, Alper; Şişman, Nejdet; Öztan, Yücel

doi:10.1046/j.1365-2230.2003.01210.x

Cited by 113 publications

(99 citation statements)

References 18 publications

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“…The most common inciting injury in various studies has been the thermal injury and it stands true in our study as well [2]. Although no age is immune to development of MU, it has been reported that the latency period between the initial insult and development of MU is inversely proportional to the age at initial insult [8]. The mean latency period in our study was 12.0 ± 4.3 years which although falls within the range reported in literature but this is also because the range reported in literature is too wide.…”

Section: Discussionsupporting

confidence: 71%

Marjolin’s Ulcer: Experience from a Developing Country

Ky¹,

Kj²,

Gautam³

et al. 2017

Surgery Curr Res

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Section: Discussionsupporting

confidence: 71%

Marjolin’s Ulcer: Experience from a Developing Country

Ky¹,

Kj²,

Gautam³

et al. 2017

Surgery Curr Res

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“…4 and M.v.H., unpublished results). Furthermore, inflammation and chronic wounds are associated with development of human SCC, as in the development of SCC in burn scars, chronic venous stasis ulcers, and discoid lupus erythematosus (28)(29)(30). Progression of actinic keratosis to SCC has recently also been shown to be associated with an inflammatory stage (31).…”

Section: Discussionmentioning

confidence: 99%

Tumor necrosis factor receptor 1-mediated signaling is required for skin cancer development induced by NF-κB inhibition

Lind

Rozell²,

Wallin³

et al. 2004

Proc. Natl. Acad. Sci. U.S.A.

106

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T he Rel͞NF-B transcription factors have a central role in several cellular processes, including proliferation, cell adhesion, apoptosis, and regulation of the immune response (1). Under nonstimulating conditions, NF-B is retained in the cytoplasm in an inactive form because of its interaction with the inhibitory proteins I Bs. In response to an activating stimulus, I B is phosphorylated by an I B kinase (IKK) complex, which targets it for degradation by the proteasome, releasing NF-B, which translocates to the nucleus, where it regulates the transcription of target genes.Evidence gathered from studies during recent years have shown that NF-B has a growth inhibitory function in the skin. Initial studies showed that overexpression of the NF-B subunits p50 or p65 in the basal layer of the murine epidermis by using a keratin 14 (K14) promoter leads to hypoplasia of the epidermis, whereas expression of a superrepressor form of the inhibitor of NF-B type ␣ (I B␣) results in hyperplasia (2). Although K14-I B␣ mice die shortly after birth (day 7), we have shown that mice with keratin 5 (K5)-directed expression of I B␣ (K5-I B␣) to the basal layer of the epidermis survive to adulthood (3). Not only do these mice develop hyperplasia of the epidermis, but the skin phenotype of K5-I B␣ mice is also characterized by an intense neutrophil-dominated inflammation of the skin and an early development of squamous cell carcinomas (SCC).Recent data suggest that human sporadic SCC may show a block in NF-B signaling based on nuclear exclusion of the RelA NF-B subunit (ref. 4 and M.v.H., unpublished results). Furthermore, it was recently shown that coexpression of a superrepressor form of I B␣ and Ha-Ras results in neoplasia resembling invasive SCC in human keratinocytes transplanted to severe combined immunodeficient (scid͞scid) mice, supporting the relevance of a NF-B block in the induction of human SCC (4).Inflammation of the skin with neutrophil infiltration and hyperproliferation is also seen in female heterozygous Ikk␥-deficient mice, which develop a condition similar to the human X-linked disorder Incontinentia Pigmenti (IP) (5, 6). IKK␥ is the regulatory subunit of the IKK complex, which, in addition, contains the two catalytic subunits IKK␣ (IKK1) and IKK␤ (IKK2) (1). It is now well established that human IP results from loss-of-function mutations in the IKK␥ gene (7). Interestingly, subungual keratoacanthoma-like tumors and cases of SCC have been reported as late manifestations of IP (8-11).The catalytic IKK␤ subunit is necessary for activation of NF-B in response to proinflammatory stimuli (1). Skin-specific deletion of the IKK␤ gene, K14-Cre͞Ikk2 FL/FL , was recently shown to result in an inflammatory phenotype with concomitant hyperproliferation of the epidermis (12), very similar to what is seen in the K5-I B␣ mice. Because the K14-Cre͞Ikk2 FL/FL mice die between day 7 and day 9 after birth, it is currently not known whether they, similar to K5-I B␣ mice, are prone to develop SCC.Besides inf lammation and hyperprolifera...

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“…4 Although initially described as a malignant transformation from a burn wound, the term Marjolin's ulcer has been used interchangeably for malignant transformation in any chronic wound, including pressure ulcers, osteomyelitis, venous stasis ulcers, urethral fistulas and anal fistulas. 2 Marjolin's ulcer may develop in various anatomical locations, although the highest incidence is in the lower extremities. 1,5 The predilection of these lesions may be due to injuries that affect the arms and legs, such as a grenade shrapnel injury in this case.…”

Section: Discussionmentioning

confidence: 99%

“…Most Marjolin's ulcers are squamous cell carcinoma (SCC) in origin (over 75%) and have been associated with various types of chronic wounds, including pressure sores, osteomyelitis and venous stasis ulcers. 1,2 Few case reports in the literature exist regarding the malignant transformation of old war scars. We present a case of SCC arising from a grenade shrapnel injury sustained over 60 years prior in a Korean War veteran.…”

Section: Introductionmentioning

confidence: 99%

Old War Scar Revisited

Wozniak

Zuo

Khan

et al. 2015

Journal of the American College of Clinical Wound Specialists

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In 1828, Jean Nicholas Marjolin, a French surgeon, first described the findings of a neoplastic development arising from a burn scar, now more commonly referred to as a Marjolin's ulcer. A Marjolin's ulcer describes malignant degeneration in any chronic wound. The majority of cases arises in burn scars and are often latent for decades. Marjolin ulcers have been widely identified in post-war time injuries. These ulcers may arise in almost any anatomical location. We report a case of an 82-year-old male that presented with a painful fluctuating mass on the right arm localized to the site of an old grenade blast injury he sustained many years earlier. While the presentation of these cases may be variable, the significance of proper management of the wounds is essential to optimal patient outcomes. An aggressive course and poor prognosis is associated with Marjolin's ulcers that degenerate into squamous cell carcinoma. Early detection and aggressive treatment/management with wide local excision and prompt coverage yield the best results when treating patients with Marjolin's ulcers.

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Thirty-one cases of Marjolin's ulcer

Cited by 113 publications

References 18 publications

Marjolin’s Ulcer: Experience from a Developing Country

Marjolin’s Ulcer: Experience from a Developing Country

Tumor necrosis factor receptor 1-mediated signaling is required for skin cancer development induced by NF-κB inhibition

Old War Scar Revisited

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