MARJOLINS ULCER OF THE FOOT CAUSED BY NONBURN TRAUMA

Marjolin's ulcers are malignancies that arise from previously traumati zed, chronically inflamed, or scarred skin. We report a case of squamo us cell carcinoma arising in a foot wound 42 years after the time of i njury. The historical background, epidemiology, pathophysiology, diagn osis, treatment, and prognosis of Marjolin's ulcer are reviewed. Diagn osis is best accomplished by punch biopsy or excision of suggestive le sions. Wide local excision is required and amputation may be necessary to achieve an adequate margin. Regional lymph node dissection should be done if regional nodes are palpable. Elective lymph node dissection is controversial but should be considered if the tumor is poorly diff erentiated. Lymph node metastases and high tumor grade indicate a poor prognosis. Clinicians should be diligent in the long-term surveillanc e of all significant scars or areas of chronic inflammation.