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Paper Details

Clinical Presentation of Two Patients with Marjolin’s Ulcer Presenting in an Area of Previously Burned Skin: A Case Report

Clinical Presentation of Two Patients with Marjolin’s Ulcer Presenting in an Area of Previously Burned Skin: A Case Report

Marko Barić

Journal Title:Acta Scientific Otolaryngology
Abstract


Background: Marjolin's ulcer (MU) refers to an aggressive ulcerating squamous cell carcinoma (SCC) presenting in an area of previ-ously traumatized, chronically inflamed, or scarred skin. They usually develop in the areas of full thickness skin burns that had been allowed for weeks to months to heal spontaneously by secondary intention or burn wounds which never healed completely over years and the unstable post-burned scars. Lower limbs represent the most frequently affected body parts. Treatment is usually surgi-cal, with a wide excision of the lesion; typically, a 2 - 5 cm margin all around is required. Despite best efforts, the overall mortality is reported to be 21%. The aim of this case report was to present two of our patients suffering from mistreated and misdiagnosed Mar-jolin’s ulcer, and to evaluate clinical presentation, diagnostic and therapeutic difficulties in this rare condition. Treatment of both pa-tients was surgical and radical, whereas in the first patient, high femoral amputation with the stump reconstruction was performed. In the second patient, after a radical excision in sano and an extirpation of supraclavicular lymph nodes, a defect was reconstructed with rotational pedicled island myocutaneous latissimus dorsi flap. Conclusion: Reconstructive surgery provided a dramatic cosmetic improvement with significant psychosocial benefit. Unfortunate-ly, high-grade tumours have significantly high amount of recurrence and positive lymph node metastases, so repeated surgical pro-cedures may be required. Keywords: Marjolin’s Ulcer; Malignant Degeneration; Post-Burned Scars and Wounds; Squamous Cell Carcinoma; Full Thickness Skin Burns; Healing by Secondary Intention