ABSTRACT

Aim

Cutaneous malignancies often develop in traumatized, degenerative, and chronically inflamed skin or scar tissues. The observations indicated that cutaneous malignancies often arise in burn scars (Marjolin's ulcer), venous ulcers, compression wounds, cystostomy sites, chronic pilonidal sinus, hidradenitis suppurativa, lupus scars, chronic lymphedema, traumatic wounds, and sites of chronic osteomyelitis.

The current study presents a differential diagnosis and treatment approach in patients who received wound care and treatment due to the presence of chronic wounds and in whom biopsy revealed malignancy.

Material and Methods

Five patients who presented to the clinic due to chronic wounds between 2008 and 2012 and in whom biopsy revealed carcinomas were included in the study. The patients were retrospectively reviewed in terms of previously administered therapies, pathological diagnosis, predisposing factors, time to malignant degeneration, reconstruction techniques, complications, and recurrence.

Results

The pathological examination revealed verrucous carcinoma in three patients and squamous cell carcinoma in two patients. The mean of malignant degeneration time was 8 years (5- 12).

Conclusion

Chronic skin irritation and exposure of the soft tissues to different growth factors, and cytotoxic factors arising due to inflammation are thought to play an important role in malignant transformation.

Providing good wound care, avoiding traumas, and obtaining biopsy from non-healing wounds to establish early diagnosis are very important in patients with chronic wounds. Squamous cell carcinoma was the most commonly encountered histological tumor type. Moreover, it must also be remembered that cutaneous malignancies can develop in patients with sustained open wounds and risk factors.