Marjolin’s ulcers in the post-burned lesions and scars

Figure 1 Marjolin's ulcer in the left popliteal fossa region in a 45 years old lady who had sustained flame burn injury at the age of 13. There is characteristic ulcer with everted edges and poorly granulating floor. The surrounding skin shows post-burned sequel. Histopathology confirmed it to be well differentiated squamous cell carcinom.

Figure 2 A 46 years male with 3 years history of ulceration and bleeding in right axilla. He had sustained scald burns at the age of 3. Biopsy confirmed it to be squamous cell carcinoma while computed tomography scan revealed metastasis in the axilla as well as chest.

Figure 3 A 63 years old male presented with two years history of slowly progressive ulceration in the post burned white skin on his upper back. He had childhood scald burns at the age of 3 years, and had received burn injury treatment with months of dressings without skin grafting. Multiple biopsies revealed squamous cell carcinoma, while computed tomography scan revealed axillary nodal invasion without chest metastasis. Culture sensitivity revealed Methicillin resistant staphylococcus and pseudomonas aeruginsa.

Figure 4 A lady aged 41, had sustained burn injury secondary to lightning 3 years ago. She had her burn injuries managed with months of dressing without skin grafting. Subsequently she had recurrent ulceration with bleeding from the unhealed wounds around the knee. Multiple biopsies of the lesions revealed well differentiated squamous cell carcinoma. The groin nodal basin was negative clinically as well as radiologically.

Figure 5 A 41 years male who had sustained flame burn injury to his left foot in childhood at the age of 4. The burn injury was managed with months of dressings and the wound never healed completely. There was history of recurrent bleeding and ulceration on the affected site. Multiple biopsies revealed moderately differentiated squamous cell carcinoma. The groin was clinically node positive.

Figure 6 A 36 years male had sustained chemical burn injury to his left cubital fossa 7 years ago. The initial burn injury was managed with dressings and had never healed completely. The patient had undergone wide local excision and split thickness skin grafting for Marjolin's ulcer three months ago. Later he presented with a recurrent nodule which was confirmed as squamous cell carcinom on histopathology while the axilla was node negative clinically.

Figure 7 Right groin metastasis secondary to Marjolin's ulcer on the right side of ankle in 57 years male. Metastatic work up revealed ascites and lung metastasis. The patient had sustained flame burn injury to the right ankle at the age of 2 years and was managed with wound dressings without skin grafting.

Figure 8 A 47 years male had sustained flame burn injury to his scalp at the age of 3. The initial burn injury was managed with months of dressings without skin grafting. Histopathology confirmed it as well differentiated squamous cell carcinoma. Computed tomography scan head and neck did not show deep structures invasion.

Figure 9 Same patient (as in Figure 8), the resected Marjolin's ulcer with wide local margins.