{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T03:25:08Z","timestamp":1761708308077},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"814","license":[{"start":{"date-parts":[[1993,8,1]],"date-time":"1993-08-01T00:00:00Z","timestamp":744163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1993,8,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>Dermatitis artefacta is a chronic skin lesion produced by self-trauma. Avoidance of further trauma, topical steroids and psychological therapy all play a part in the treatment of such lesions. Unresolved lesions may become large and disfiguring and subject to infection. We report a case of one such lesion in an elderly woman who persistently excoriated a cholecystectomy scar over 40 years. Malignant transformation occurred in a manner analogous to the neoplastic change observed in other types of chronic ulcer (Marjolin's ulcer). The squamous cell carcinoma presented with widespread metastases from which the patient eventually died. Recent literature concerning Marjolin's ulcers is reviewed and it is noted that this is the first reported case of death caused by malignant change in dermatitis artefacta.<\/jats:p>","DOI":"10.1136\/pgmj.69.814.648","type":"journal-article","created":{"date-parts":[[2008,12,29]],"date-time":"2008-12-29T21:25:21Z","timestamp":1230585921000},"page":"648-650","source":"Crossref","is-referenced-by-count":17,"title":["Malignant change in dermatitis artefacta"],"prefix":"10.1093","volume":"69","author":[{"given":"J C","family":"Alcolado","sequence":"first","affiliation":[{"name":"Department of Medicine, Undergraduate Centre, East Birmingham Hospital , Bordesley Green East, Birmingham, B9 5ST, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Ray","sequence":"additional","affiliation":[{"name":"Department of Medicine, Undergraduate Centre, East Birmingham Hospital , Bordesley Green East, Birmingham, B9 5ST, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Baxter","sequence":"additional","affiliation":[{"name":"Department of Medicine, Undergraduate Centre, East Birmingham Hospital , Bordesley Green East, Birmingham, B9 5ST, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C W","family":"Edwards","sequence":"additional","affiliation":[{"name":"Department of Medicine, Undergraduate Centre, East Birmingham Hospital , Bordesley Green East, Birmingham, B9 5ST, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P M","family":"Dodson","sequence":"additional","affiliation":[{"name":"Department of Medicine, Undergraduate Centre, East Birmingham Hospital , Bordesley Green East, Birmingham, B9 5ST, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1993,8,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1016\/S0140-6736(84)91177-2","article-title":"Dermatological pathomimicry: a form of patient maladjustment","volume":"i:","author":"Millard, L.G.","year":"1984","unstructured":"Millard, L.G. Dermatological pathomimicry: a form of patient maladjustment. Lancet 1984, i: 969-971.","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1192\/bjp.149.5.636","article-title":"Psychogenic skin disease: a review of 35 cases","volume":"149","author":"Shappard, N.P.; O'Loughlin, S.; Malone, J.P.","year":"1986","unstructured":"Shappard, N.P., O'Loughlin, S. & Malone, J.P. Psychogenic skin disease: a review of 35 cases. Br J Psych 1986, 149: 636-643.","journal-title":"Br J Psych"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1097\/00004630-199105000-00004","article-title":"Malignancy and chronic wounds: Marjolin's ulcer","volume":"12","author":"Fishman, J.R.; Parker, M.G.","year":"1991","unstructured":"Fishman, J.R. & Parker, M.G. Malignancy and chronic wounds: Marjolin's ulcer. J Burn Care Rehabil 1991, 12: 218-223.","journal-title":"J Burn Care Rehabil"},{"issue":"67","key":"ref_4","first-page":"831","article-title":"Marjolin's ulcer complicating a pressure ulcer: case report and literature review","volume":"1986","author":"Berkwits, L.; Yarkony, G.M.; Lewis, V.","unstructured":"Berkwits, L., Yarkony, G.M. & Lewis, V. Marjolin's ulcer complicating a pressure ulcer: case report and literature review. Arch Phys Med Rehabil 1986, 67: 831-833.","journal-title":"Arch Phys Med Rehabil"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/0007-1226(84)90131-0","article-title":"Penetrating Marjolin's ulcer of scalp involving bone and dura mater treated by wide excision and direct application of a split skin graft on the brain: a 10-year follow-up","volume":"37","author":"Mallard, G.F.; Landolt, A.","year":"1984","unstructured":"Mallard, G.F. & Landolt, A. Penetrating Marjolin's ulcer of scalp involving bone and dura mater treated by wide excision and direct application of a split skin graft on the brain: a 10-year follow-up. Br J Plast Surg 1984, 37: 463-467.","journal-title":"Br J Plast Surg"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1111\/j.1464-410X.1987.tb04819.x","article-title":"Marjolin's ulcer of urethrostomies and urethroplasty","volume":"59","author":"Houston, W.","year":"1987","unstructured":"Houston, W. Marjolin's ulcer of urethrostomies and urethroplasty. Br J Urol 1987, 59: 192.","journal-title":"Br J Urol"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/0020-1383(91)90116-V","article-title":"Marjolin's ulcer complicating a poorly fabricated prosthesis","volume":"22","author":"Mahaisavariya, B.; Mahaisavariya, P.","year":"1991","unstructured":"Mahaisavariya, B. & Mahaisavariya, P. Marjolin's ulcer complicating a poorly fabricated prosthesis. Injury 1991, 22: 423-424.","journal-title":"Injury"},{"issue":"33","key":"ref_8","first-page":"185","article-title":"Squamous cell carcinoma arising in acne conglobata","volume":"1984","author":"Camisa, C.","unstructured":"Camisa, C. Squamous cell carcinoma arising in acne conglobata. Cutis 1984, 33: 185-187.","journal-title":"Cutis"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/00000372-198404000-00015","article-title":"Marjolin's ulcer. Report of two cases and evidence that Marjolin did not describe cancer arising in scars ofburns","volume":"6","author":"Steffen, C.","year":"1984","unstructured":"Steffen, C. Marjolin's ulcer. Report of two cases and evidence that Marjolin did not describe cancer arising in scars ofburns. Am J Dermopathol 1984, 6: 187-193.","journal-title":"Am J Dermopathol"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1097\/00004630-199009000-00016","article-title":"Marjolin's ulcer: a review and reevaluation of a difficult problem","volume":"11","author":"Fleming, M.D.; Hunt, J.L.; Purdue, G.F.; Sandstad, J.","year":"1990","unstructured":"Fleming, M.D., Hunt, J.L., Purdue, G.F. & Sandstad, J. Marjolin's ulcer: a review and reevaluation of a difficult problem. J Burn Care Rehabil 1990, 11: 460-469.","journal-title":"J Burn Care Rehabil"},{"issue":"77","key":"ref_11","first-page":"998","article-title":"Carcinoma of the hand: a 20-year experience","volume":"1984","author":"Bean, D.J.; Rees, R.S.; O'Leary, J.P.; Lynch, J.B.","unstructured":"Bean, D.J., Rees, R.S., O'Leary, J.P. & Lynch, J.B. Carcinoma of the hand: a 20-year experience. South Med J 1984, 77: 998-1000.","journal-title":"South Med J"}],"container-title":["Postgraduate Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/69\/814\/648\/50073139\/postgradmedj-69-648.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/69\/814\/648\/50073139\/postgradmedj-69-648.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T13:44:36Z","timestamp":1682603076000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/pmj\/article\/69\/814\/648\/7062944"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1993,8,1]]},"references-count":11,"journal-issue":{"issue":"814","published-online":{"date-parts":[[1993,8,1]]},"published-print":{"date-parts":[[1993,8,1]]}},"URL":"https:\/\/doi.org\/10.1136\/pgmj.69.814.648","relation":{},"ISSN":["0032-5473","1469-0756"],"issn-type":[{"value":"0032-5473","type":"print"},{"value":"1469-0756","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[1993,8]]},"published":{"date-parts":[[1993,8,1]]}}}