Melanoma arising in a chronic pressure ulcer

The malignant transformation of chronic wounds is rare and is seen most frequently in burn scars. Despite the infrequency of such a transformation, the management of chronic ulcers requires close follow up, including skin biopsies of all suspected lesions. Chronic ulceration may predispose patients to the development of malignancies such as basal cell carcinoma, squamous cell carcinoma, leiomyosarcoma, and melanoma.1,2 Here, we report a case of melanoma that arose in a chronic pressure ulcer. A 35-year-old man developed a complication following an injection at 6 months of age, which resulted in paraplegia, but he remained ambulatory with the aid of a wheelchair. A pressure ulcer developed in the sacral area 15 years after his injury. He had been treated conservatively, which resulted in variation in the size of the ulcer over the past 19 years. However, the ulcer had grown in the last year

The effect of pre-operative conventional and hyperfractionated radiotherapy schedules on wound healing and tensile strength in rats: an experimental study

. We examined the effects of pre-operative conventional andhyperfractionated radiotherapy schedules on wound healing and tensile strength in90 female Wistar rats weighing between 182 and 240 g. The animals wererandomized into three groups (n ¼ 30 each). Group I was sham-irradiated. GroupII (conventional) received 20 daily fractions of 200 cGy, to a total dose of4000 cGy. Group III (hyperfractionated) received 40 fractions of 120 cGy, twicedaily, to a total dose of 4800 cGy. Four weeks after radiotherapy, incision andprimary repair with simple suturing was performed on one side of the neck.Twenty-one days after wounding, all the rats were sacrificed....

Metastatic Basal Cell Carcinoma: A Case Report

An 86 year old lady presented to her GP with a 2 month historyof right hip and left thigh pain. Pelvic plain x-rays revealed a lyticlesion in the left femur and right acetabulum. Thorough clinical examination found an 80 x 60 mm exophytic tumor with an ulceratedsurface on her left shoulder. This had been present for over 4 years,the patient believing it ‘just a patch of eczema’. A subsequent CTchest, abdomen and pelvis revealed further bony lesions in her sternum, first rib and sacrum. A biopsy of the left shoulder lesion confirmed ulcerated basal cell carcinama (BCC). Hisological and immunohistochemical examination of a biopsy from the bony lesionin the sternum and first rib confirmed a diagnosis of metastaic BCC.Our patient commenced on treatment with imiquimod cream to theprimary BCC, had a rod inserted into her left femur in order to prevent a pathological fracture and was offered palliative radiotherapyfor the metastatic deposits, which she declined. She died six weekslater. Worldwide BCC incidence is increasing, but has very highcure rates with early complete surgical excision. Metastatic BCC isvery rare but incidence is higher with larger tumors, because largevessel blood supply may facilitate haematological seeding of the tumor. Once it metastasises, BCC is highly malignant with short survival times, usually measurable in months. Our patient is likely tohave had metastatic disease for some months prior to presentation.Keywords: Carcinoma; Basal Cell; Metastatic; Secondary; Neoplasm

Annals of Plastic Surgery

Pigmented skin lesions are common lesions. Some of them are malignant and the

others are benign. It is very important to make the correct diagnosis before

treatment. Early diagnosis and treatment are needed to obtain a cure for

malignant pigmented skin lesions. 1 We present a case that was similar to some

pigmented lesions clinically and needed to be differentiated from this type of

lesion. We could not find a similar report in the literature.