We report squamous cell carcinoma (SCC) arising within a burn scar. The eponym "Marjolin's ulcer" was derived from a French surgeon Jean Nicholas Marjolin, who observed and classified cellular changes in burned skin and coined the term "ulcere cancroide". We review literature and current diagnostic modalities and treatment of this not so uncommon disease.
The pathophysiology of Marjolin's ulcer is unclear. Two per cent of skin malignancies are estimated to arise within burn scars. According to concurrent epidemiological analyses, squamous cell carcinoma is the most frequent malignancy to arise within burned/chronically wounded skin (75-96%), followed by basal cell carcinoma (12%), melanoma (3%), sarcoma (isolated cases).
If Marjolin's ulcer diagnosis is established, wide local excision (at least 2 cm lateral margins) comprising fascia should be performed. The wound could be closed with transposed cutaneo-subcutaneous flap or with free flap. Long term treatment outcome is relatively good, but strict and prolonged follow-up is mandatory.
Financed by the National Centre for Research and Development under grant No. SP/I/1/77065/10 by the strategic scientific research and experimental development program:
SYNAT - “Interdisciplinary System for Interactive Scientific and Scientific-Technical Information”.