Infected epidermal inclusion cyst mimicking Marjolins ulcer in a case of Post Burn Contracture axilla

摘要

Background: We describe here a very rare presentation of Post Burn Contracture axilla in which an underlying infected epidermal inclusion cyst was mimicking Marjolin’s ulcer in its presentation.Material and Methods: The patient with Post Burn contracture axilla was treated with release and split skin grafting after excision of the epidermal inclusion cyst.Results: Axilla was released and grafted. Patient was kept on strict splintage and physiotherapy programme to encourage movements. The patient is on regular follow-up and further monitored physiotherapy has been planned to provide a better functional and aesthetic limb.Conclusion: The presentation of Post Burn Contracture axilla described here has not been mentioned in world literature so far and its presentation is a matter of discussion. Opinions regarding possibilities of such presentation are invited from experts in the field. Introduction We describe here a case of Post burn contracture axilla with an underlying infected epidermal inclusion cyst which was mimicking Marjolis ulcer in its presentation. Axilla was released and epidermal inclusion cyst was excised. Patient also had a long standing anterior dislocation of the shoulder which was treated by an open approach in the same sitting. No case of this kind has been reported to date. Case Report A sixty two year-old adult male presented with a Post burn contracture of the left axilla since past 42 years. Patient had developed a non healing ulcer over the contracture site since past 6 years. Clinical examination revealed that the non healing ulcer had everted edges and an indurated base. The ulcer was present on the area adjoining the anterior axillatry fold. The cupola was obliterared. The ulcer was 3.2 X 2.4 cm in size. [Fig 1] The axilla had a long standing Post burn contracture with obliteration of cupola. The skin overlying the contracture was hyperpigmented and atrophic. No lymph nodes were palpable in the supraclavicular region. Palpation of axillary nodes was not possible in view of the contracture band. The movements at the axilla was limited to slight abduction and limited flexion and extension. Movements at the elbow, wrist and joints in the hands were normal. Clinically, the ulcer presented the picture of marjolins ulcer with a history of non healing since past 6 years in long standing Post burn contracture axilla, everted edges and indurated base.