Marjolin’s ulcer

#### The bottom line The tissue viability nurse refers a 72 year old woman with lower limb venous stasis and a six year history of a non-healing ulcer on her shin (figure⇓) to her general practitioner. The GP refers her to the plastic surgery team, where incisional biopsy of the ulcer confirms squamous cell carcinoma (SCC), consistent with a Marjolin’s ulcer. Further examination shows palpable lymph nodes in the right inguinal region. Marjolin’s ulcer of the right anterolateral leg. The ulcer has an irregular border and base. It had bled intermittently and had increased in size despite compression bandaging Marjolin’s ulcers are tumours that most commonly arise from areas of chronic inflammation or injury and develop over many years.1 They are most common in old burn scars, but they are also seen in traumatic wounds, venous stasis ulcers, pressure sores, …