Ten years of experience in chronic ulcers and malignant transformation

Abstract

Malignant degeneration of wounds is rare and often misdiagnosed. Delay in diagnosis may result in a worse prognosis. The aim of this study is to determine the number of skin cancers associated with chronic skin ulcers in our facility over a period of 10 years. Between January 2002 and December 2012, a total of about 1000 patients had consulted with us for chronic wounds, especially of vascular, diabetic and traumatic origin and pressure ulcers. Thirteen skin cancers had been detected: seven squamous cell and five basal cell carcinomas and one melanoma. We highlight how important it is to be aware of the signs suggesting a malignant change and the importance of biopsy at regular intervals during the life cycle of any chronic wound.

Keywords: Basal cell carcinoma; Chronic wound; Malignant transformation; Marjolin's ulcer; Squamous cell carcinoma.

Figure 1

Non‐healing diabetic ulcer on the left leg in a 74‐year‐old woman.

Figure 2

Arteriovenous ulcer of the leg with an increase in size and recurrent bleeding in a 65‐year‐old woman.

Figure 3

Chronic wounds of traumatic origin on the right leg in 56‐year‐old man.

Figure 4

Arteriovenous ulcer of the leg in a 66‐year‐old man. (A) Ulcer of the leg showing shiny granulation tissue, preoperative view. (B) Macroscopic appearance of the lesion. (C) Intraoperative view. (D) Recurrence of the cancer after 2 months.