Toussaint Frédéric, Erdmann Michael, Berking Carola, Erfurt-Berge Cornelia
Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Ulmenweg 18, 91054 Erlangen, Germany.
Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nürnberg (CCC ER-EMN), 91054 Erlangen, Germany.
J Clin Med. 2021 May 22;10(11):2251. doi: 10.3390/jcm10112251.
Our purpose was to collect data on the incidence of malignant skin tumours presenting as chronic leg or foot ulcers in a tertiary centre, and to analyse the frequency and type of initial clinical misdiagnoses in these cases. A retrospective chart review of cases with melanoma or other malignant neoplasms of the skin of the lower extremity treated in a tertiary centre during January 2010 until February 2020 was conducted to identify cases that presented as chronic ulcers. Out of 673 cases, 26 (3.9%) were identified with a total of 27 malignant tumours presenting as chronic ulcers of the lower leg or foot. Therefrom, seven were diagnosed as melanoma, eight as squamous cell carcinoma, and twelve as basal cell carcinoma. The mean interval until diagnosis for all tumour types was 44.4 months (median 24 months). A delay in correct treatment occurred in 12 out of 26 cases (46%) as a result of misdiagnosis with subsequent treatment as chronic leg or foot ulcers of a different etiology. Misdiagnoses were venous ulcer, traumatic wound, mixed arterial and venous ulcer, arterial ulcer, and ulcer of an unknown origin. Malignant ulcers presenting as chronic ulcers are rare, but often lead to misdiagnosis.
我们的目的是收集三级医疗中心以慢性腿部或足部溃疡形式出现的恶性皮肤肿瘤的发病率数据，并分析这些病例最初临床误诊的频率和类型。对2010年1月至2020年2月期间在三级医疗中心接受治疗的下肢黑色素瘤或其他皮肤恶性肿瘤病例进行回顾性病历审查，以确定以慢性溃疡形式出现的病例。在673例病例中，确定了26例（3.9%），共有27个恶性肿瘤表现为小腿或足部慢性溃疡。其中，7例被诊断为黑色素瘤，8例为鳞状细胞癌，12例为基底细胞癌。所有肿瘤类型从出现症状到确诊的平均间隔时间为44.4个月（中位数为24个月）。26例中有12例（46%）因误诊而导致正确治疗延迟，随后被当作不同病因的慢性腿部或足部溃疡进行治疗。误诊包括静脉溃疡、创伤性伤口、动静脉混合性溃疡、动脉溃疡和不明原因的溃疡。以慢性溃疡形式出现的恶性溃疡很少见，但常常导致误诊。
