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Adniana Nareswari
Bagian Ilmu Kesehatan Kulit dan Kelamin, Fakultas Kedokteran, Universitas Sebelas Maret Surakarta/RSUD Dr. Moewardi, Surakarta
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Ulkus Marjolin Yang Berkembang Dari Ulkus Trofik Kronis Pada Pasien Kusta Adniana Nareswari; Harijono Kariosentono; Nugrohoaji Dharmawan; Muhammad Eko Irawanto; Nurrachmat Mulianto
MEDICINUS Vol 34 No 2 (2021): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (256.255 KB) | DOI: 10.56951/medicinus.v34i2.67

Abstract

Marjolin’s ulcer is a malignant complication of chronic ulcer. Changes in ulcer lesions to malignancy can be caused by chronic irritation, infection, decreased vascular variation, and increased expression of proto-oncogene. The most common histopathological form of Marjolin's ulcer is squamous cell carcinoma. A 55-year-old man, complaining of a protruding wound on his left hand that has not healed since three years ago. The patient was diagnosed with leprosy 30 years ago with a history of incomplete treatment. On physical examination, the left palmar region showed solitary ulcer, ±10x8x1.5 cm in size, nodular surface, reddish, hard consistency, with bulging and irregular edge. Slit-skin smear (SSS) examination with Ziehl-Neelsen staining found abundant acid-fast bacilli. Histopathological examination of the ulcer edge shows appearance of epithelial tumor, with differentiated epidermal cells invading the dermis, tumor cells arranged focally and concentrically with a mass of keratin appeared as horn pearl cells. Fite-Faraco staining found abundant M. leprae acid-fast bacilli. Based on the patient’s medical history and clinical examination, patient was diagnosed with Marjolin's ulcer in multibacillary (MB) leprosy. Patient was treated with MB multidrug therapy for 12 months and below-wrist amputation.
Co-Authors Dharmawan, Nugrohoaji Harijono Kariosentono Muhammad Eko Irawanto Nurrachmat Mulianto