{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T02:44:32Z","timestamp":1785725072214,"version":"3.56.0"},"reference-count":14,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Chronic leg wounds are common in wound\u2010care practice and are most often attributed to vascular or inflammatory etiologies. Rarely, they may represent or conceal underlying malignancy, and delayed recognition can lead to inappropriate management and poor outcomes. We aimed to evaluate diagnostic delay, clinical warning signs, histopathological findings, management strategies, and outcomes in patients with malignancy\u2010associated chronic leg wounds treated in a tertiary wound\u2010care setting. We conducted a retrospective observational study of consecutive patients with chronic lower\u2010leg wounds (&gt;\u20096\u2009weeks' duration) diagnosed with underlying malignancy between 2015 and 2022. Clinical characteristics, time to biopsy, histopathological findings, treatment, and outcomes were analysed descriptively. Among 328 patients with chronic leg wounds, eight (2.4%) were diagnosed with malignant etiologies. Mean ulcer duration at biopsy was 11.3\u2009months (range 6\u201324), exceeding guideline\u2010recommended timelines. All wounds failed to heal despite standard care. Common red\u2010flag features included disproportionate pain, necrosis or bleeding, and atypical appearance. Earlier biopsy and multidisciplinary management were associated with improved wound outcomes, whereas prolonged diagnostic delay correlated with advanced disease and poor prognosis. Malignancy should be considered in any chronic leg wound failing to improve within 4\u201312\u2009weeks or showing atypical features, and early biopsy is essential to optimise outcomes.<\/jats:p>","DOI":"10.1111\/iwj.70991","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T09:52:42Z","timestamp":1782985962000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Malignancy in Chronic Leg Wounds: Diagnostic Delay and Clinical Implications in a Tertiary Wound\u2010Care Cohort"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2646-3903","authenticated-orcid":false,"given":"Marcela","family":"Nowak","sequence":"first","affiliation":[{"name":"Department of Biomedical and Clinical Sciences Link\u00f6ping University  Link\u00f6ping Sweden"},{"name":"Clinical Department of Dermatology and Venereology in \u00d6sterg\u00f6tland Region \u00d6sterg\u00f6tland  Link\u00f6ping Sweden"},{"name":"Department of Dermatology, Venereology and Allergology Medical University of Gdansk  Gdansk Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorota","family":"Piechota","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology Medical University of Gdansk  Gdansk Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4018-6706","authenticated-orcid":false,"given":"Wioletta","family":"Bara\u0144ska\u2010Rybak","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology Medical University of Gdansk  Gdansk Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.12994"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10112251"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0190-9622(93)70173-Q"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000007445"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102008\u201004\u2010152850"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdm381"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.2019.28.Sup3a.S1"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0007\u20100963.2001.04615.x"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.35279\/jowm2023.24.02.sup01"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19870301)59:5<1046::AID-CNCR2820590533>3.0.CO;2-6"},{"issue":"9","key":"e_1_2_12_12_1","first-page":"2010","article-title":"Transcription Profile of Kaposi's Sarcoma\u2010Associated Herpesvirus in Primary Kaposi's Sarcoma Lesions as Determined by Real\u2010Time PCR Arrays","volume":"63","author":"Dittmer D. 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