Malignant change after 18 months in a lower limb ulcer: acute Marjolinʹs revisited

Lower limb ulcers present a common clinical problem and are at risk of malignant change. A Marjolinʹs ulcer has traditionally been regarded as malignant change in a long standing ulcer and/or scar tissue. We report a case of Marjolinʹs degeneration that developed in an ulcer only 18 months following the initial injury. Such a short latent period has not been reported for over 70 years. This report highlights the possibility of early Marjolinʹs change and we propose a ranked diagnostic screen to aid in early identification of possible malignant change, based on the current published evidence.