Скачать или смотреть 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


📌 Definition
Marjolin’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/marjolin...


🧠 Flashcards:
https://www.passthemsra.com/topic/marjolin...


💬 Accordion Q&A Notes:
https://www.passthemsra.com/topic/marjolin...


🚀 Rapid Quiz:
https://www.passthemsra.com/topic/marjolin...


🧪 Topic Quiz:
https://www.passthemsra.com/quizzes/marjol...


🎓 Full Dermatology Course:
https://www.passthemsra.com/courses/dermat...


📣 All resources are part of the Dermatology for the MSRA course at:
👉 https://www.passthemsra.com


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