This came through my inbox today. I find this sort of information very useful in deciding how to manage chronic ulcers and when to think about biopsy.
Chronic leg ulcers that don’t heal after three months of appropriate treatment have an overall skin cancer frequency of 10.4 percent, according to a study published online Feb. 20 in the Archives of Dermatology
WEDNESDAY, Feb. 22 (HealthDay News) — Chronic leg ulcers (CLUs) that don’t heal after three months of appropriate treatment have an overall skin cancer frequency of 10.4 percent, according to a study published online Feb. 20 in the Archives of Dermatology.
To investigate the frequency of skin cancers associated with CLUs, Patricia Senet, M.D., of Université Paris X, and colleagues studied 144 ambulatory or hospitalized patients with 154 CLUs attributed to venous and/or peripheral arterial disease(s), with increasing wound size (area and/or depth), despite receiving appropriate standard treatment for at least three months. Upon inclusion in the study, at least two 6-mm punch biopsies (one at the wound edge and one in the wound bed) were systematically performed.
The researchers found that the overall frequency of skin cancer in the CLUs was 10.4 percent; with nine squamous cell carcinomas, five basal cell carcinomas, one melanoma, and one leiomyosarcoma. More than half (56.3 percent) had persisted for at least three years. Older age, abnormal excessive granulation tissue at the wound edges, high clinical suspicion of cancer, and number of biopsies were significantly associated with skin cancer on univariate analysis. Neither wound area or duration, were significantly associated with skin cancer.
“The combined primary ulcerated cancer or malignant transformation frequency was sufficiently high in CLUs referred to tertiary care centers to consider systematic biopsy of a wound refractory to three months or more of appropriate treatment,” write the authors.