Marjolin’s Ulcer: Mismanaged Chronic Cutaneous Ulcers

Asuquo ME, Nwagbara VI, Omo

Abstract

Background: In developing countries, chronic cutaneous ulcers, scars, and osteomyelitic sinuses are common lesions. Marjolin’s ulcer is a malignant tumour that may arise from any of the above lesions. It may be misdiagnosed for infection and mismanaged as such. Method: We evaluated the clinical histories, treatment, and outcomes of patients who presented to the University of Calabar Teaching Hospital, Calabar with histologic diagnosis of Marjolin’s ulcer from January 2010 to December 2012. Results: The seven patients were 4 males and 3 females whose ages ranged from 28-70 years (mean 45.7 years). Trauma was the leading cause of injury resulting in ulceration [road traffic injuries- 4(57%), burns-2(29%)] while the other patient suffered diabetic foot ulcer. All the injuries involved the limbs [upper-1(14%), lower -6(86%)]. The histologic diagnosis in all the patients was squamous cell carcinoma with a mean latency period of 16.3 years. Late presentation with advanced loco-regional disease precluded curative surgery with poor outcomes. Conclusion: Marjolin’s ulcer is preventable and areas of intervention have been highlighted. Educations concerning prevention, risk of chronic ulceration, early presentation, prompt and proper treatment is advocated for improved outcome.