Department of Surgery, AIC Kijabe Hospital, Kijabe, 00220, Kenya.
World J Surg. 2010 Oct;34(10):2272-7. doi: 10.1007/s00268-010-0727-6.
Cutaneous malignancies are considered rare among Africans. Trauma, its sequelae, and other chronic non-healing wounds are known to predispose to malignant degeneration. Not much is known of the demographics of Marjolin's ulcers in sub-Saharan Africa.
Pathology records on patients suspected to have Marjolin's ulcers submitted to the Pathology Department were extracted from a database of 75,124 specimens. A review of the English literature on Marjolin's ulcers from Nigeria, a sub-Saharan country, was also performed.
Of 210 specimens from suspected Marjolin's ulcers, 167 records had a histological diagnosis of malignancy, with a male to female ratio of 1:1.4, and a mean age of 48 years (range: 4-97 years). There were 163 (97.6%) squamous cell carcinomas, 3 (1.8%) sarcomas, and 1 (0.6%) malignant melanoma. Burn scars, chronic ulcers, osteomyelitis, and "other" ulcers constituted 82 (49%), 70 (42%), 9 (5.4%), and 6 (3.6%), respectively. Subjects in six sub-Saharan Marjolin's ulcer studies had a mean age between 36 and 42 years, with a mean latent period 16 years.
Marjolin's ulcers in sub-Saharan African have a shorter latent period, and they occur in younger patients. Provision of early stable wound cover is essential for prevention of malignant degeneration of scars, while early appropriate intervention is crucial in the treatment of chronic ulcers.
皮肤恶性肿瘤在非洲人群中较为罕见。创伤及其后遗症和其他慢性不愈伤口已知可导致恶性转化。关于撒哈拉以南非洲的马约林溃疡的人口统计学特征，我们知之甚少。
从一个包含 75124 个标本的数据库中提取了疑似马约林溃疡的患者的病理记录。还对来自撒哈拉以南国家尼日利亚的马约林溃疡的英文文献进行了回顾。
在 210 份疑似马约林溃疡的标本中，有 167 份记录有恶性肿瘤的组织学诊断，男女比例为 1:1.4，平均年龄为 48 岁（范围：4-97 岁）。有 163 例（97.6%）为鳞状细胞癌，3 例（1.8%）为肉瘤，1 例（0.6%）为恶性黑色素瘤。烧伤疤痕、慢性溃疡、骨髓炎和“其他”溃疡分别占 82（49%）、70（42%）、9（5.4%）和 6（3.6%）。在 6 项撒哈拉以南非洲马约林溃疡研究中，受试者的平均年龄在 36 至 42 岁之间，平均潜伏期为 16 年。
撒哈拉以南非洲的马约林溃疡潜伏期较短，发生在更年轻的患者中。提供早期稳定的伤口覆盖对于预防疤痕的恶性转化至关重要，而早期适当的干预对于慢性溃疡的治疗至关重要。
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