Marjolin’s Ulcers in sub-Saharan Africa
- 140 Downloads
Cutaneous malignancies are considered rare among Africans. Trauma, its sequelae, and other chronic non-healing wounds are known to predispose to malignant degeneration. Not much is known of the demographics of Marjolin’s ulcers in sub-Saharan Africa.
Pathology records on patients suspected to have Marjolin’s ulcers submitted to the Pathology Department were extracted from a database of 75,124 specimens. A review of the English literature on Marjolin’s ulcers from Nigeria, a sub-Saharan country, was also performed.
Of 210 specimens from suspected Marjolin’s ulcers, 167 records had a histological diagnosis of malignancy, with a male to female ratio of 1:1.4, and a mean age of 48 years (range: 4–97 years). There were 163 (97.6%) squamous cell carcinomas, 3 (1.8%) sarcomas, and 1 (0.6%) malignant melanoma. Burn scars, chronic ulcers, osteomyelitis, and “other” ulcers constituted 82 (49%), 70 (42%), 9 (5.4%), and 6 (3.6%), respectively. Subjects in six sub-Saharan Marjolin’s ulcer studies had a mean age between 36 and 42 years, with a mean latent period 16 years.
Marjolin’s ulcers in sub-Saharan African have a shorter latent period, and they occur in younger patients. Provision of early stable wound cover is essential for prevention of malignant degeneration of scars, while early appropriate intervention is crucial in the treatment of chronic ulcers.
KeywordsBasal Cell Carcinoma Chronic Ulcer Malignant Degeneration Road Traffic Injury Cutaneous Malignancy
The author is grateful to the AIC Kijabe Hospital Pathology Department staff for assistance in retrieving patient records.
Conflict of interest
The author has declared no conflicts of interest.
- 6.Lawrence EA (1952) Carcinoma arising in the scars of thermal burns. Surg Obstet Gynecol 95:579–588Google Scholar
- 9.Malheiro E, Pinto A, Choupina M et al (2001) Marjolin’s ulcer of the scalp: case report and literature review. Ann Burns Fire Disasters 15:115–118Google Scholar
- 20.Templeton AC (1973) Tumours in a tropical country: a survey of Uganda, 1964–1968. Springer, Berlin, pp 182–183Google Scholar
- 24.Lawrance REA (1952) Carcinoma arising in burn scars. Surg Gynecol Obstet 95:579–588Google Scholar
- 25.Nthumba PM, Oliech JS (2005) Outcome of moderate and severe thermal injuries at Kenyatta National Hospital. East Cent Afr J Surg 10:37–42Google Scholar
- 28.Olaitan PB, Ogbonnaya IS (2007) Marjolin’s ulcers on the thigh two years after burn. Ann Burns Fire Disasters 20:159–160Google Scholar
- 31.Bostwick J, Pendergrast WJ, Vasconez LO (1975) Marjolin’s ulcer: an immunologically privileged tumor? Plast Reconstr Surg 57:66–69Google Scholar