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.

Marjolin's ulcer is a rare and often aggressive cutaneous malignancy that arises in previously traumatized or chronically inflamed skin, particularly after burns. We reviewed 264 burns cases treated in our departments to assess the frequency and clinicopathological features of this malignant complication. We found 31 cases of Marjolin's ulcer and a further 14 cases of nonmalignant ulceration at previous burn sites. Eighteen Marjolin's ulcers were located on the extremities, six on the scalp, six on the trunk, and one on the nose. Most malignancies were squamous cell carcinomas. The average time lag between the burns and subsequent malignant ulceration was 19 years. Four of the malignant ulcers had spread to regional lymph nodes, but there were no distant metastases. This study emphasizes that Marjolin's ulcer should be considered as a significant postburn complication.

The effect of blunt trauma on fat tissue may be explained by different theories. We summarized possible mechanisms into two groups according to our observations and review of the literature: The first was related to mature adiposities and mainly a mechanical effect, and the second was differentiations of the preadipocytes to lipoma by the promoting factors. We speculate that only traumas that serve as a cause of fat necrosis may trigger the formation of the lipoma, and local inflammation secondary to fat necrosis may affect adipocytes and promote new formation of lipoma.

Background: Matrix metalloproteinases [MMPs], which degrade the extracellular matrix, play an important role in the invasion and metastasis of squamous cell carcinomas. One MMP, MMP-13, is thought to play a central role in MMP activation. The purpose of this study was to investigate MMP-13 and TIMP-1 expression in squamous cell carcinomas of the head and neck and to relate these levels of expression to histologic patterns of invasion.

BackgroundCutaneous horns (cornu cutaneum) are uncommon lesions consisting of keratotic material resembling that of an animal horn. Cutaneous horn may arise from a wide range of the epidermal lesions, which may be benign, premalignant or malignant.Patients and methodsIn this respective study, we describe our experience of eleven patients with cutaneous horn treated at our centre between January 2000 and January 2004. The clinical, pathological and treatment details were extracted from the case records. Data is presented as frequency distribution.ResultsThere were 8 male and 3 female patients with a median age of 57 years. Most of the lesions were located on the ear, hand and scalp. Surgical resection was carried out in all the lesions. There were two cases of squamous cell carcinoma, and one case of basal cell carcinoma, other 8 cases were benign. None of the lesions recurred and no adjuvant treatment was given to any of the malignant lesions.ConclusionCutaneous horn is a clinical diagnosis that refers to a conical projection above the surface of the skin. The lesions typically occurs in sun exposed areas, particularly the face, ear, nose, forearms, and dorsum of hands. Even though our 60% of the cutaneous horns are benign possibility of skin cancer should always be kept in mind.