Marjolin’s Ulcer

A Marjolin’s Ulcer  is defined as the malignant  degeneration of a chronic wound or scar. This condition was first described in 1828 by Jean Marjolin, a French surgeon, in a patient with burn scars which would not heal.

These malignant transformations can be seen in burn scars, pressure ulcers,  and venous stasis ulcers.
On biopsy these ulcers have been most commonly identified as squamous cell and basal cell carcinomas.
Marjolin ulcers are more common in women than in men and occur at the average age of 53 to 59 years. The most common site of Marjolin ulcer formation is in the lower extremities followed by the head and face with upper extremities.
The cause of this malignant transformation in chronic wounds is not well understood, but there are numerous plausible theories for this phenomenon.

Toxic substances released from the disordered wound healing can result in cell malignant changes. Chronic irritation at the site of injury may be responsible for some of the cellular changes. Altered immune response may play a role in malignant tissue.
Early diagnosis of these lesions is critical. Biopsy of recalcitrant wounds is very important.
Surgical intervention is necessary for the treatment of these lesions, many recommend amputation of the extremity and lymph node.
However rare this condition, it is still a real possibility in patients with chronic wounds to avoid amputation of the affected limb with persistent diagnosis early and the awareness that it exists.