Malignancy in chronic leg ulcers

Objective: To evaluate the frequency of malignant ulcers in patients presenting with leg ulcers.Design: A descriptive study from data collected between July 1988 and June 1995 from 981 patients (2448 ulcers) attending a leg ulcer clinic.Setting: A specialised leg ulcer clinic at a tertiary leaching hospital.Subjects: 43 patients with 55 malignant skin lesions.Outcome measures: Tissue biopsies in ulcerated lesions that suggested malignancy or were not responding to appropriate treatment.Results: Forty-three patients were found to have malignant lesions on the legs, giving a frequency of malignant ulcers of 4.4 per 100 leg ulcer patients, or 2.2 per 100 leg ulcers, Seventy-five per cent of the malignant ulcers were basal cell carcinoma and 25% were squamous cell carcinoma.Conclusions: Malignant skin changes are common in chronic leg ulcers. A biopsy should be taken from all suspicious ulcers or ulcers that do not respond to appropriate treatment.