Marjolin's Ulcer: When a Chronic Wound Turns Cancerous

Dr. G explains Marjolin ulcer, a form of squamous cell carcinoma that can arise in long-standing, chronically inflamed or scarred wounds—especially diabetic foot ulcers—and why early recognition matters for limb salvage and survival. Key signs include changing or hypertrophic margins, rolled or friable edges, unexplained bleeding, disproportionate pain, non-healing despite treatment, and nearby enlarged lymph nodes. Diagnosis requires a deep biopsy and imaging; treatment often involves wide surgical excision, possible lymph node assessment, and sometimes amputation or adjunct radiation. Prevention and vigilance are crucial: optimize diabetes and vascular care, monitor chronic wounds closely, and refer promptly for suspicious changes. Emerging research on biomarkers, targeted therapies, and AI imaging aims to detect malignant transformation earlier.