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

机译:烧焦后的病灶和疤痕中马焦林的溃疡

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摘要

Marjolin’s ulcer (MU) represents malignant degeneration that typically ensues over a period of time in the post-burned lesions and scars or any other chronic wound. This review highlights various facets of the presentation and management of MUs that originate from post-burned lesions. The incidence of MUs in such lesions is reported to be 0.77%-2%. This malignancy characteristically develops 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. In the majority of cases, the MU is a squamous cell carcinoma (SCC). The MUs contribute to an overall 2% of all SCCs and 0.03% of all basal cell carcinomas of the skin. Clinically MUs present in two major morphologic forms. The commoner form is the flat, indurated, ulcerative variety while the less common form is the exophytic papillary variety. Lower limbs represent the most frequently affected body parts. Surgical resection of the primary tumor with 2-4 cm horizontal clearance margin, nodal clearance and radiotherapy constitute the cornerstones of effective oncologic management. Despite best efforts, the overall mortality is reported to be 21%.
机译:Marjolin溃疡(MU)代表恶性变性,通常在一段时间后发生在烧伤后的病变和疤痕或任何其他慢性伤口中。这篇综述突出了来自烧伤后病变的MU的表现和管理的各个方面。据报道,在这种病变中MU的发生率为0.77%-2%。这种恶性肿瘤的特征是在全层皮肤烧伤的区域发展,这些皮肤烧伤已经通过继发性意图自发治愈了数周至数月,或者烧伤了多年未完全治愈的伤口以及不稳定的烧伤后疤痕。在大多数情况下,MU是鳞状细胞癌(SCC)。 MU占全部SCC的2%,占皮肤所有基底细胞癌的0.03%。临床上MU以两种主要形态学形式存在。较常见的形式是扁平,硬结,溃疡性变种,而较不常见的形式是外生的乳头状变种。下肢代表受影响最频繁的身体部位。具有2-4 cm水平间隙余量,淋巴结清除和放射疗法的原发肿瘤的手术切除是有效进行肿瘤治疗的基础。尽管尽了最大努力,但据报道总死亡率为21%。

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