Marjolin ulceration as an example of an atypical wound in lower leg ulceration

Chronic skin damage can predispose to malignant transformation, known as a Marjolin ulcer. Squamous cell carcinoma is the most common type of malignant change in a chronic wound. The aim of this study was to present the case of a 50-year-old male patient diagnosed with a Marjolin ulcer. A retrospective analysis of 1236 patients with chronic wounds (excluding those related to oncological treatment) treated and cared for at the wound treatment clinic of the Podkarpackie Oncology Centre in Brzozów between 2020 and 2024 revealed 7 cases of malignant tumours developing in wounds. From this group, a case of lower leg ulceration in a 50-year-old man was selected for further analysis. The TIMERS and Wound Hygiene concepts were used to guide the management of the wound, with measures including maggot therapy and active dressings employed to cleanse the wound and reduce inflammation. Given the prolonged period of ineffective treatment, microbiological material and tissues were sampled for histopathological evaluation according to the protocol. The obtained test results clearly indicated a cancerous component, and the patient was referred for further diagnostics and oncological treatment. It is imperative to histopathologically evaluate any wound that fails to undergo healing processes within 4-6 weeks despite the recommended measures. In the event of a malignant substrate being confirmed, local measures are primarily focused on wound management, and the treatment undertaken should be multidisciplinary based on grading, staging, and typing. It is crucial to raise awareness and provide targeted education for medical staff to draw attention to rare and atypical wounds.