Skip to main content
SpringerLink
Log in

Parallelen zwischen Wundheilung, chronisch entzündlichen Dermatosen und Neoplasien

Wissenswertes für die Praxis

Parallels between wound healing, chronic inflammatory skin diseases and neoplasia

Clinical aspects

  • Leitthema
  • Published:
Der Hautarzt Aims and scope Submit manuscript

Zusammenfassung

Im Bereich persistierender Wunden, langzeitig bestehender Narben, Verbrennungen und chronisch entzündlicher Hauterkrankungen kann es zur malignen Transformation kommen. Die Neoplasien manifestieren sich häufig als spinozelluläre Karzinome, aber auch Basalzellkarzinome sind beschrieben. Die Entwicklung von malignen Tumoren im Bereich ulzerierender Läsionen und chronisch entzündlicher Dermatosen ist eine schwerwiegende Komplikation, und ihre frühzeitige Diagnose und Therapie stellen wichtige Prognosefaktoren dar. Dieser Beitrag soll die Zusammenhänge zwischen Prozessen in der Wundheilung, chronisch entzündlichen Zuständen und der Karzinogenese anhand klinischer Beispiele aufzeigen und Hinweise für das praktische Vorgehen in Diagnostik und Therapie liefern.

Abstract

Chronic wounds, scars, burns and recalcitrant chronic inflammatory skin lesions can give rise to malignancy. These neoplasias are usually squamous cell carcinomas but basal cell carcinomas can also develop. Tumorigenesis is a severe complication of chronic ulcers as well as certain inflammatory skin diseases; early diagnosis is critical for prognosis. This article describes parallels between wound healing, chronic inflammatory skin diseases and carcinogenesis and provides advice on practical aspects of diagnosis and therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4

Literatur

  1. Ardabili M, Gambichler T, Rotterdam S et al (2003) Metastatic cutaneous squamous cell carcinoma arising from a previous area of chronic hypertrophic lichen planus. Dermatol Online J 9:10

    PubMed  Google Scholar 

  2. Arwert EN, Hoste E, Watt FM (2012) Epithelial stem cells, wound healing and cancer. Nat Rev Cancer 12:170–180

    Article  CAS  PubMed  Google Scholar 

  3. Baldursson BT, Hedblad MA, Beitner H et al (1999) Squamous cell carcinoma complicating chronic venous leg ulceration: a study of the histopathology, course and survival in 25 patients. Br J Dermatol 140:1148–1152

    Article  CAS  PubMed  Google Scholar 

  4. Bovenschen HJ, Seyger MM, Van de Kerkhof PC (2005) Plaque psoriasis vs. atopic dermatitis and lichen planus: a comparison for lesional T-cell subsets, epidermal proliferation and differentiation. Br J Dermatol 153:72–78

    Article  CAS  PubMed  Google Scholar 

  5. Breuninger H, Eigentler T, Bootz F et al (2013) Brief S 2k guidelines- – Cutaneous squamous cell carcinoma. J Dtsch Dermatol Ges 11(Suppl 3):37–45

    Google Scholar 

  6. Chalya PL, Mabula JB, Rambau P et al (2012) Marjolin’s ulcers at a university teaching hospital in Northwestern Tanzania: a retrospective review of 56 cases. World J Surg Oncol 10:38

    Article  PubMed Central  PubMed  Google Scholar 

  7. Chang HY, Sneddon JB, Alizadeh AA et al (2004) Gene expression signature of fibroblast serum response predicts human cancer progression: similarities between tumors and wounds. PLoS Biol 2:206–214

    Article  CAS  Google Scholar 

  8. Chang HY, Nuyten DS, Sneddon JB et al (2005) Robustness, scalability, and integration of a wound-response gene expression signature in predicting breast cancer survival. Proc Natl Acad Sci USA 102:3738–3743

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Combemale P, Bousquet M, Kanitakis J et al (2007) Malignant transformation of leg ulcers: a retrospective study of 85 cases. J Eur Acad Dermatol Venereol 21:935–941

    Article  CAS  PubMed  Google Scholar 

  10. Copcu E, Aktas A, Sişman N et al (2003) Thirty-one cases of Marjolin’s ulcer. Clin Exp Dermatol 28:138–410

    Article  CAS  PubMed  Google Scholar 

  11. Coussens LM, Werb Z (2002) Inflammation and cancer. Nature 420:860-867

  12. DaCosta J (1903) Carcinomatous changes in an area of chronic ulceration, or Marjolin’s ulcer. Ann Surg 37:496–502

    CAS  Google Scholar 

  13. Deutsche Gesellschaft für Wundheilung und Wundbehandlung e. V (2014) S 3-Leitlinie 091-001 „Lokaltherapie chronischer Wunden bei den Risiken CVI, PAVK und Diabetes mellitus“. www. awmf.org

  14. Dissemond J, Augustin M, Eming SA et al (2014) Modern wound care – practical aspects of non-interventional topical treatment of patients with chronic wounds. J Dtsch Dermatol Ges 12:541–554

    PubMed  Google Scholar 

  15. Eming SA, Krieg T, Davidson JM (2007) Inflammation in wound repair: molecular and cellular mechanisms. J Invest Dermatol 127:514–525

    Article  CAS  PubMed  Google Scholar 

  16. Eryilmaz R, Bilecik T, Okan I et al (2014) Recurrent squamous cell carcinoma arising in a neglected pilonidal sinus: report of a case and literature review. Int J Clin Exp Med 7:446–450

    PubMed Central  PubMed  Google Scholar 

  17. Fernandes JD, Rivitti-Machado MC, Nakano J et al (2014) Clinical, dermoscopic and histopathological features of melanocytic nevi in dystrophic epidermolysis bullosa. J Dtsch Dermatol Ges 12:237–242

    PubMed  Google Scholar 

  18. Fine JD, Bruckner-Tuderman L, Eady RA et al (2014) Inherited epidermolysis bullosa: updated recommendations on diagnosis and classification. J Am Acad Dermatol 2014 Jun;70(6):1103–1126

    Article  PubMed  Google Scholar 

  19. Fine JD, Johnson LB, Weiner M et al (2009) Epidermolysis bullosa and the risk of life-threatening cancers: the national EB registry experience, 1986-2006. J Am Acad Dermatol 60:203–211

    Article  PubMed  Google Scholar 

  20. Flower C, Gaskin D, Bhamjee S et al (2013) High-risk variants of cutaneous squamous cell carcinoma in patients with discoid lupus erythematosus: a case series. Lupus 22:736–739

    Article  CAS  PubMed  Google Scholar 

  21. Friedl TK, Flaig MJ, Rupec RA (2011) Verrucous squamous cell carcinoma complicating hypertrophic lichen planus. Three case reports and review of the literature. Hautarzt 62:40–45

    Article  CAS  PubMed  Google Scholar 

  22. Gabrielli A, Avvedimento EV, Krieg T (2009) Scleroderma. N Engl J Med 360:1989–2003

    Article  CAS  PubMed  Google Scholar 

  23. Goldberg G, Eisen AZ, Bauer EA (1988) Tissue stress and tumor promotion. Possible relevance to epidermolysis bullosa. Arch Dermatol 124:737–741

    Article  CAS  PubMed  Google Scholar 

  24. Grönhagen CM, Fored CM, Granath F et al (2012) Increased risk of cancer among 3663 patients with cutaneous lupus erythematosus: a Swedish nationwide cohort study. Br J Dermatol 166:1053–1059

    Article  PubMed  Google Scholar 

  25. Gurtner GC, Werner S, Barrandon Y et al (2008) Wound repair and regeneration. Nature 453:314–321

    Article  CAS  PubMed  Google Scholar 

  26. Hanahan D, Weinberg RA (2011) Hallmarks of cancer: the next generation. Cell 144:646–674

    Article  CAS  PubMed  Google Scholar 

  27. Has C, Bruckner-Tudermann L (2011) Epidermolysis bullosa. Diagnosis and therapy. Hautarzt 62:82–90

    Article  CAS  PubMed  Google Scholar 

  28. Herschel S, Laske J, Stein A (2014) Squamous cell carcinoma arising in hidradenitis suppurativa. J Dtsch Dermatol Ges 12:417–419

    PubMed  Google Scholar 

  29. Hodzic-Avdagic N, Kuhn A, Megahed M et al (2004) Verrucous squamous cell carcinoma developing in hypertrophic lichen planus. Hautarzt 55:385–387

    Article  CAS  PubMed  Google Scholar 

  30. Hynes RO (2009) The extracellular matrix: not just pretty fibrils. Science 326:1216–1219

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  31. Kowal-Vern A, Criswell BK (2005) Burn scar neoplasms: a literature review and statistical analysis. Burns 31:403-413

  32. Kreuter A, Krieg T, Worm M et al (2009) AWMF Guideline no.013/066. Diagnosis and therapy of circumscribed scleroderma. J Dtsch Dermatol Ges 7(Suppl. 6):1–14

    Google Scholar 

  33. Lavogiez C, Delaporte E, Darras-Vercambre S (2010) Clinicopathological study of 13 cases of squamous cell carcinoma complicating hidradenitis suppurativa. Dermatology 220:147–153

    Article  CAS  PubMed  Google Scholar 

  34. Lehnert W, Kohl K, Riebe H et al (2008) Therapie maligner Tumoren auf venösen Beinulzera. Hautarzt 59:912–916

    Article  CAS  PubMed  Google Scholar 

  35. Lim C, Tschuchnigg M, Lim J (2006) Squamous cell carcinoma arising in an area of long-standing necrobiosis lipoidica. J Cutan Pathol 33:581–583

    Article  PubMed  Google Scholar 

  36. Mallipeddi R, Wessagowit V, South AP et al (2004) Reduced expression of insulin-like growth factor-binding protein-3 (IGFBP-3) in squamous cell carcinoma complicating recessive dystrophic epidermolysis bullosa. J Invest Dermatol 122:1302–1309

    Article  CAS  PubMed  Google Scholar 

  37. Marjolin JN (1828) Ulcère verruqueux. Dictionnaire de Médecine 21:46

  38. Matsushita S, Ishihara T, Kageshita T et al (2004) Multiple squamous cell carcinomas arising in lesions of discoid lupus erythematosus. J Dermatol 31:73–75

    Article  PubMed  Google Scholar 

  39. Müller-Decker K (2011) Cyclooxygenase-dependent signaling is causally linked to non-melanoma skin carcinogenesis: Pharmacological, genetic, and clinical evidence. Cancer Metastasis Rev 30:343–361

    Article  PubMed  Google Scholar 

  40. Onesti MG, Fino P, Fioramonti P et al. (2013) Ten years of experience in chronic ulcers and malignant transformation. Int Wound J Jul 19. doi:10.1111/iwj.12134 [Epub ahead of print]

  41. Ortiz-Urda S, Garcia J, Green CL et al (2005) Type VII collagen is required for Ras-driven human epidermal tumorigenesis. Science 307:1773–1176

    Article  CAS  PubMed  Google Scholar 

  42. Pandey MK, Gupta P, Khanna AK (2014) Squamous cell carcinoma arising from pilonidal sinus. Int Wound J 11:354–356

    Article  PubMed  Google Scholar 

  43. Panuncialman J, Hammerman S, Carson P et al (2010) Wound edge biopsy sites in chronic wounds heal rapidly and do not result in delayed overall healing of the wounds. Wound Repair Regen 18:21–25

    Article  PubMed Central  PubMed  Google Scholar 

  44. Parodi PC, Riberti C, Draganic Stinco D et al (2001) Squamous cell carcinoma arising in a patient with long-standing pansclerotic morphea. Br J Dermatol 144:417–419

    Article  CAS  PubMed  Google Scholar 

  45. Pedersen TX, Leethanakul C, Patel V et al (2003) Laser capture microdissection-based in vivo genomic profiling of wound keratinocytes identifies similarities and differences to squamous cell carcinoma. Oncogene 22:3964–3976

    Article  CAS  PubMed  Google Scholar 

  46. Pourreyron C, Cox G, Mao X et al (2007) Patients with recessive dystrophic epidermolysis bullosa develop squamous-cell carcinoma regardless of type VII collagen expression. J Invest Dermatol 127:2438–2444

    Article  CAS  PubMed  Google Scholar 

  47. Reich-Schupke S, Altmeyer P, Kreuter A et al (2008) Development of spinocellular carcinoma in a long-lasting and therapy resistant venous ulcer – two case studies. J Dtsch Dermatol Ges 6:569–572

    Article  PubMed  Google Scholar 

  48. Saleh DB, Williams AM, Smith IM (2011) Cutaneous squamous cell carcinoma arising within generalised morphea. J Plast Reconstr Aesthet Surg 64:149–152

    Article  Google Scholar 

  49. Santos-Juanes J, Galache C, Curto JR et al (2004) Squamous cell carcinoma arising in long-standing necrobiosis lipoidica. J Eur Acad Dermatol Venereol 18:199–200

    Article  CAS  PubMed  Google Scholar 

  50. Schäfer M, Werner S (2008) Cancer as an overhealing wound: an old hypothesis revisited. Nature 9:628–638

    Google Scholar 

  51. Schnirring-Judge M (2010) Malignant transformation of a chronic venous stasis ulcer to basal cell carcinoma in a diabetic patient: case study and review of the pathophysiology. J Foot Ankle Surg 49:75–79

    Article  PubMed  Google Scholar 

  52. Senet P, Combemale P, Debure C et al (2012) Malignancy and chronic leg ulcers. The value of systematic wound biopsies: a prospective, multicentre, cross-sectional study. Arch Dermatol 148:704–708

    Article  PubMed  Google Scholar 

  53. Sigurgeirsson B, Lindelöf B (1991) Lichen planus and malignancy. An epidemiologic study of 2071 patients and a review of the literature. Arch Dermatol 127:1684–1688

  54. Smith RW (1850) Observations upon the ‘warty ulcer of Marjolin’. Dublin quart Quart J med Med Sci 9:257–274

  55. Smoller BA, McNutt NS, Carter DM et al (1990) Recessive dystrophic epidermolysis bullosa skin displays a chronic growth-activated immunophenotype. Implications for carcinogenesis. Arch Dermatol 126:78–83

    Article  CAS  PubMed  Google Scholar 

  56. Stern RS, PUVA FS (2012) The risk of squamous cell and basal cell cancer associated with psoralen and ultraviolet A therapy: a 30-year prospective study. J Am Acad Dermatol 66:553–562

    Article  CAS  PubMed  Google Scholar 

  57. Tao J, Zhang X, Guo N et al (2011) Squamous cell carcinoma complicating discoid lupus erythematosus in Chinese patients: Review review of the literature, 1964-2010. J Am Acad Dermatol 66:695–696

    Article  Google Scholar 

  58. Uva L, Freitas J, Soares de Almeida L et al. (2013) Squamous cell carcinoma arising in ulcerated necrobiosis lipoidica diabeticorum. Int Wound J 2013 Dec 26. doi: 10.1111/iwj.12206 [Epub ahead of print]

  59. Virchow R (1863) Aetiologie der neoplastischen Geschwulste. von August Hirschwald, Berlin

  60. Wollina U, Buslau M, Heinig B et al (2007) Disabling pansclerotic morphea of childhood poses a high risk of chronic ulceration of the skin and squamous cell carcinoma. Int J Low Extrem Wounds 6:291–298

    Article  PubMed  Google Scholar 

  61. Wong SY, Reiter JF (2011) Wounding mobilizes hair follicle stem cells to form tumors. Proc Natl Acad Sci USA 108:4093–4098

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  62. Zhang H, Landmann F, Zahreddine H et al (2011) A tension-induced mechanotransduction pathway promotes epithelial morphogenesis. Nature 471:99–103

    Article  CAS  PubMed  Google Scholar 

Download references

Einhaltung ethischer Richtlinien

Interessenkonflikt

A. Brown, I. Tantcheva-Poor und S.A. Eming geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

Author information

Authors and Affiliations

  1. Klinik und Poliklinik für Dermatologie und Venerologie, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland

    A. Brown, I. Tantcheva-Poor &  S.A. Eming

Authors
  1. A. Brown
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. I. Tantcheva-Poor
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S.A. Eming
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S.A. Eming.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Brown, A., Tantcheva-Poor, I. & Eming, S. Parallelen zwischen Wundheilung, chronisch entzündlichen Dermatosen und Neoplasien. Hautarzt 65, 934–943 (2014). https://doi.org/10.1007/s00105-014-3524-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00105-014-3524-6

Schlüsselwörter

Keywords

Search

Navigation