Dermatology · Skin Tumors (Malignant Melanoma, SCC, BCC)

A 68-year-old with a 15-year history of chronic venous ulcer develops a rapidly growing fungating mass at the ulcer margin. Biopsy shows invasive squamous cell carcinoma. This specific SCC subtype arising from chronic non-healing wounds or scars is called:

  • A Keratoacanthoma type
  • B Bowen's disease progressing to invasive SCC
  • C Erythroplasia of Queyrat
  • D Marjolin's ulcer
Correct answer: D. Marjolin's ulcer

Explanation

Marjolin's ulcer is a well-differentiated squamous cell carcinoma (rarely basal cell carcinoma or melanoma) arising from chronic non-healing wounds, burn scars, sinus tracts, or chronic ulcers. The transformation is characterized by a long latency period (15-25 years) followed by rapid, aggressive growth. Marjolin's ulcer is characterized by lack of pain (due to scarred nerves), lack of regional lymphadenopathy until late stages (due to blocked lymphatics from scarring), and more aggressive behavior than sun-induced SCC. Keratoacanthoma is a rapidly growing but usually self-involuting lesion. Bowen's disease and erythroplasia of Queyrat are in-situ squamous cell carcinomas.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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