From burn scar to cancer: A case highlights the danger of Marjolin ulcer after decades

Marjolin ulcer is a rare but highly aggressive skin cancer that arises in long-standing burn scars, chronic wounds, or areas of persistent inflammation. While it most commonly develops as squamous cell carcinoma (SCC), it often lies dormant for decades before emerging—and when it does, it carries significantly higher risks of recurrence and spread than conventional skin cancers.

In a new case report, doctors describe a 72-year-old man who sought care for a slow-growing, itchy tumor on the back of his left thumb. The lesion had started as a small ulcer in the center of a 30-year-old burn scar. Initially treated with antibiotic ointment for a simple scar infection, it failed to heal and gradually grew into a thick, crusted, wart-like mass measuring 3 cm × 3 cm.

Biopsy confirmed well-differentiated invasive SCC, characteristic of Marjolin ulcer. Imaging showed the cancer had not spread to deeper tissues or lymph nodes. The patient underwent successful surgical removal with clear margins followed by skin grafting, and remained cancer-free after one year of follow-up.

The report emphasizes that Marjolin ulcer has local recurrence rates of 10%–37% and distant metastasis rates up to 22%—far higher than typical SCC. Any new growth, persistent sore, or unusual change in an old scar warrants immediate medical attention and biopsy.

The work titled “Marjolin Ulcer in the Hand” was published on May 27, 2026, in Skin.