Marjolin's Ulcer: Modern Analysis of an Ancient Problem

Abstract

The authors' review suggests that there is much variability in the anatomical location of Marjolin's ulcers, with the majority occurring in wounds of the upper and lower extremities. Marjolin's ulcer appears to be preventable if early wound coverage is undertaken. Countries with limited access to medical treatment report a high number of Marjolin's ulcers compared with more developed regions.

Marjolin’s Ulcer: Experience from a Developing Country

“…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].…”

“…Both these characters were later identified by Robert William Smith but it was not until 1903 when JC Dacosta described these ulcers and coined the term "Marjolin's Ulcer" that this was established as a distinct pathology [1]. Although MU can arise from any chronic wound or non-healing scar, neglected burn scars are the commonest site of its origin [2]. This entity is thought to be rare in developed countries but it is common in developing countries because of a higher incidence of thermal injuries due to use of coal, cow dung cakes, wood and kerosene oil as fuel for cooking.…”

Old War Scar Revisited

“…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. The transformation from ulcer to malignancy is typically slow and the pathogenesis is unclear, 5,6 but it is most likely multifactorial.…”

“…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. The transformation from ulcer to malignancy is typically slow and the pathogenesis is unclear, 5,6 but it is most likely multifactorial. 7 Chronic foreign body induced inflammation from retained shrapnel fragments appears to be the cause in our patient's case.…”

Marjolin’s Ulcer

“…The transition time is variable, ranging from three months to 63 years. The average transition time is 26 years [3]. Over the years the transition time is getting shorter.…”