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Squamous cell carcinomas in chronic venous leg ulcers. Data of the German Marjolin Registry and review
Author(s) -
ReichSchupke Stefanie,
Doerler Martin,
Wollina Uwe,
Dissemond Joachim,
Horn Thomas,
Strölin Anke,
ErfurtBerge Cornelia,
Stücker Markus
Publication year - 2015
Publication title -
jddg: journal der deutschen dermatologischen gesellschaft
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 60
eISSN - 1610-0387
pISSN - 1610-0379
DOI - 10.1111/ddg.12649
Subject(s) - medicine , venous leg ulcer , basal cell , wound care , chronic wound , complication , surgery , dermatology , cancer , wound healing
Summary Background Secondary squamous cell carcinoma (SCC) is a rare complication of chronic venous leg ulcers. So far, little is known about its pathophysiology and clinical behavior. Initiated by the working group “Wound Healing” (AGW) of the German Society of Dermatology (DDG), it is the objective of the current Marjolin registry to collect cases of SCC arising in venous ulcers, in order to evaluate diagnostic characteristics. Patients and Methods All members of the AGW received questionnaires inquiring about basic patient data, ulcer characteristics, and therapy conducted. Results From 2010 to 2013, 30 patients (20 women, 10 men) from six tertiary wound care centers were registered. Mean age was 76.17 years. The average duration of venous leg ulcers prior to SCC diagnosis was 15.93 years. Suspicious wound characteristics primarily included: pain (n = 3), therapy resistance (n = 27), and fetor (n = 12) as well as clinical appearance (n = 10) with atypical morphology, nodular wound bed, and hypergranulation. Conclusions Atypical morphology or changes in appearance as well as therapy resistance despite optimal care (6–12 weeks) should prompt physicians to take spindle‐shaped, if necessary multiple and serial, biopsies. Primary risk factors for malignant transformation include patient age and ulcer duration.