A Clinical Study on Squamous Cell Carcinoma in Chronic Ulcer in Leprosy

Kim, Ik Dong; Lee, Soo Young; Kim, Poong Taek; Park, Byung Chul; Choi, Young Wook; Kyung, Hee Soo

Abstract

Trophic ulcers are one of the common complication of leprosy. Factors of mslignant transformation in trophic ulcer are lower cell mediated immunity in leprosy, chronic infection of the ulcer, chronic & repeated ulceration, chronic osteomyelitis & calcaneal spurs and arcinogenic effect of dapsone (Arora & Mukhija 1987). Job & Riedel (1964) first reported cases of squamous cell carcinoma arising in plantar ulcers in leprosy. Later it was reported by others, but there are only few reports for long term follow-up. We analyzed the 36 cases of the squamous cell carcinoma in leprosy who were treated at the Leprosy Mission, Jesus Hospital which is affiliated with Kyungpook University Hospital between 1978 and 1987. The result were as follows:1. The man : woman ratio was 5: 1, and mean age was 52 years. 2. The carcinoma occurred chiefly in patients of the lepromatous groups. 3. The mean leprosy duration was 30 years and mean ulcer duration was 25 yesrs. 4. The most frequent site was foot (21 cases, 58%). 5. The treatments were smputation (30 csses, 83%), wide exciaion & free skin graft (4 cases, 11%), excision & radiotherapy (1 csses ) and excisional biopsy (1 cases). 6. The inguinal lymph node metastases were 16 cases (44.4%), and 7 cases of those were died, 5 cases were recurred in local aras & lymph node. 7. In long duration of chronic ulcer in lepra, squamous cell carcinoma should be suspected.