Neoplasia maligna en cicatriz de quemadura: úlcera de Marjolin: informe de dos casos y revisión de la literatura / Malignant neoplasm in burn scar: Marjolin's ulcer: report of two cases and review of the literature

BACKGROUND: Marjolin's ulcer forms part of a group of neoplasms that originate in a burn scar, a phenomenon associated with superficial tissue trauma. The frequency of Marjolin's ulcer is low and represents between 2 and 5% of all squamous cell carcinomas of the skin. This condition is found three times more frequently in men than in women and is thought to be more aggressive than conventional squamous cell carcinoma of the skin. CLINICAL CASES: We present two cases of squamous cell carcinoma that originated on a burn scar. 41 year old woman with gasoline burn on the left foot, 3 months old, in whom an exofitic ulcerated lesion on the right calcaneum region has evolved since she was 32 years old. Left transtibial amputation was decided. Another woman who started its suffering 9 years after a thorax burn with a progressive fungus lesion on the scar area. For its size and as it was a high degree neoplasia, surgical resection and radiotherapy to the zone of the primary with 50 Gy in 25 fractions was decided. CONCLUSIONS: Marjolin's ulcer usually occurs in old burn sites that were not skin grafted and were left to heal secondarily. Although it is believed that there is a latency period of 25-40 years after burn injury before the occurrence of malignancy, this may occur in a period as short as 3 months. Recurrence after radical surgery is 14.7%. Nonetheless, because of the aggressive behavior of this type of cancer, appropriate radical treatment allows an adequate control of the disease. Early grafting of the burn site can prevent the formation a malignant neoplasm. This condition should be suspected in a non-healing chronic ulcer on a burn scar.

Ulcera fistulizada por picadura de animal marino: estudio de un caso tratado con laser de Helio-Neón / Necrotic ulcer for stings of marine animal: study of a case treated with Helium-Neon laser

Se presenta un paciente masculino de 30 años de edad, que sufrió en el dorso del pie derecho una picadura de animal marino (raya) cuando cruzaba la desembocadura de un río. No se procedió de inmediato a realizar las medidas específicas para neutralizar la acción proteolítica de la sustancia inoculada; 48 horas después del accidente presentó edema del pie derecho y fiebre. A la semana siguiente presentaba una úlcera necrótica en el sitio de inoculación con un trayecto fistuloso que llegaba hasta las partes blandas de la región plantar. El paciente fue tratado con laser gaseoso de Helio-Neón obteniendo la curación total sin recidivas a las 20 sesiones.