Squamous cell carcinoma arising in a chronic perineal wound in a patient with long-standing cutaneous Crohn's disease

Cutaneous squamous cell carcinoma (SCC) is an invasive, malignant tumor with metastatic potential. This tumor can arise from various precursor lesions, including ulcers, actinic keratoses, and leukoplakia. A Marjolin ulcer is an aggressive malignancy of the skin, most commonly SCC, arising in chronic wounds or scars. Transformation from a chronic wound to SCC is rare and slow with an unknown pathogenesis, although proposed mechanisms include nonspecific or chronic antigenic stimulation.1,2 Malignantly transformed wounds are challenging to differentiate from primary chronic ulcers, so having a high suspicion for SCC and diagnosis in a timely manner is key.