Derm: Marjolin’s Ulcer: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Marjolin’s Ulcer🎧 A deep dive into this aggressive malignancy arising from chronic wounds – vital for exams and spotting danger in clinical practice.🧠 Key Learning Points📌 DefinitionMarjolin’s Ulcer is a rare but aggressive skin cancer, most often squamous cell carcinoma, arising from chronic non-healing wounds, burn scars, or longstanding ulcers. It has a long latency period (often decades) and carries a poor prognosis if missed.📌 Causes & Risk Factors• Chronic non-healing wounds (especially burn scars)• Longstanding pressure ulcers• Chronic osteomyelitis sinuses• Repeated trauma or infection to scars• Immunosuppression (reduced immune surveillance)• Environmental carcinogen exposure🧠 Memory Tip: "Burns and Beyond" – Think burns, bedsores, and chronic inflammation📌 Pathophysiology• Chronic inflammation → ongoing repair → genetic mutations accumulate• Repeated cell turnover in damaged tissue triggers malignant transformation• Most commonly leads to SCC, but can also evolve into BCC or melanoma📌 Symptoms• Non-healing ulcer at site of old scar or wound• New or worsening pain, bleeding, foul-smelling discharge• Induration (firmness), ulceration, or nodularity in scar• Irregular, raised, rolled borders• Changes after decades of stability📌 Differential Diagnosis• Venous/arterial/diabetic ulcers• Pyoderma gangrenosum• Chronic traumatic ulcers• Primary cutaneous SCC• Infected scars📌 Diagnosis• Biopsy is essential – confirms SCC or other malignancy• Examine regional lymph nodes• Ultrasound or CT imaging to check for local invasion or metastasis• Full staging needed for prognosis and management decisions📌 Management• Multidisciplinary team (MDT) approach• Wide local excision with clear margins is first-line• Mohs surgery in sensitive locations• Reconstruction with skin grafts or flaps• Consider amputation if extensive local disease• Adjuvant radiotherapy or chemotherapy for incomplete resection or spread• Targeted therapy in select cases📌 Complications• Local recurrence• Regional or distant metastases (e.g. lymph nodes, lungs, liver)• Functional loss from surgery/amputation• Poor wound healing• Psychological impact📌 Prognosis• Depends on depth of invasion, tumour size, and presence of metastasis• Early diagnosis and full excision improve outcomes• Delay in recognition leads to high morbidity and mortality🧠 Key Takeaway: Any sudden change in a longstanding wound or scar should raise alarm bells. Biopsy it.📎 More MSRA Resources for Marjolin’s Ulcer📝 Revision Notes:https://www.passthemsra.com/topic/marjolins-ulcer-revision-notes/🧠 Flashcards:https://www.passthemsra.com/topic/marjolins-ulcer-flashcards/💬 Accordion Q&A Notes:https://www.passthemsra.com/topic/marjolins-ulcer-accordion-qa-notes/🚀 Rapid Quiz:https://www.passthemsra.com/topic/marjolins-ulcer-rapid-quiz/🧪 Topic Quiz:https://www.passthemsra.com/quizzes/marjolin-s-ulcer/🎓 Full Dermatology Course:https://www.passthemsra.com/courses/dermatology-for-the-msra/📣 All resources are part of the Dermatology for the MSRA course at:👉 https://www.passthemsra.comHashtags#MSRA #MSRARevision #MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQandANotes #MSRAAccordions #MultiSpecialtyRecruitmentAssessment #MarjolinsUlcer #Dermatology #ChronicWoundCancer #PassTheMSRA