{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T14:54:41Z","timestamp":1784818481223,"version":"3.55.0"},"reference-count":42,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPHS"],"abstract":"<jats:p>Background: Burn scars are recognized risk factors for malignant skin transformation, most notably Marjolin\u2019s ulcer (MU). Despite extensive documentation in case reports and series, the epidemiological characteristics and prognosis of burn scar-related skin cancers have lacked large-scale systematic synthesis.\nMethods: We conducted a systematic review in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, registered with PROSPERO (CRD42024545404), covering literature from PubMed, Scopus, and Web of Science up to 18 January 2024. Eligible studies included case reports, case series, and observational studies reporting any type of skin cancer in burn scars. Data were extracted on demographics, burn and tumor characteristics, treatment, latency, outcomes, and risk of bias using Joanna Briggs Institute tools.\nResults: A total of 211 studies reporting 830 cases were included. The mean latency period from burn injury to cancer diagnosis was 21.7 years (SD = 19.6). Males constituted 53% of patients, with third-degree burns predominating (89.37%) and lower limbs being the most affected site (33.59%). Squamous cell carcinoma (SCC) was the most frequent malignancy (67.19%), followed by basal cell carcinoma (BCC, 3.83%) and other cancers (15.33%). Recurrence occurred in 13.2% of cases; mortality was 6.96%. SCC accounted for most deaths (63.8%), while melanoma and sarcoma exhibited high rates of recurrence and mortality. Lymph node metastasis and distant metastasis were found in 7.56 and 4.74% of cases, respectively.\nConclusion: Skin cancers arising from burn scars, especially SCC, demonstrate aggressive clinical behavior with significant morbidity and mortality. Reduced latency periods and high metastatic potential highlight the importance of vigilant, long-term surveillance and radical initial treatment. This review provides a contemporary benchmark for epidemiological understanding and supports calls for international registries, molecular diagnostics, and standardized management protocols for burn scar malignancies.<\/jats:p>","DOI":"10.2340\/jphs.v61.45793","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T12:35:30Z","timestamp":1776947730000},"page":"86-90","source":"Crossref","is-referenced-by-count":1,"title":["Characteristics and prognosis of skin cancer arising from burn scars: a systematic review"],"prefix":"10.2340","volume":"61","author":[{"given":"Abdulmajeed","family":"Alhadlaq","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibraheem M.","family":"Kereet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basma","family":"Kamel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kainat","family":"Jahangir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nada G.","family":"Hamam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Ashraf","family":"Shehab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Hisham","family":"Alamin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed S.A.","family":"Osman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salma","family":"Rechid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Ahmed","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Elsaid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"152223","doi-asserted-by":"crossref","unstructured":"Lee HB, Han SE, Chang LS, et al. Malignant melanoma on a thermal burn scar. Arch Craniofac Surg. 2019;20(1):58\u201361.","DOI":"10.7181\/acfs.2018.02103"},{"key":"152224","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.7181\/acfs.2018.02103","DOI":"10.7181\/acfs.2018.02103"},{"key":"152225","doi-asserted-by":"crossref","unstructured":"Xiao H, Deng K, Liu R, et al. A review of 31 cases of Marjolin\u2019s ulcer on scalp: is it necessary to preventively remove the scar? Int Wound J. 2019;16(2):479\u2013485.","DOI":"10.1111\/iwj.13058"},{"key":"152226","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1111\/iwj.13058","DOI":"10.1111\/iwj.13058"},{"key":"152227","doi-asserted-by":"crossref","unstructured":"Fleming MD, Hunt JL, Purdue GF, et al. Marjolin\u2019s ulcer: a review and reevaluation of a difficult problem. J Burn Care Rehabil. 1990;11(5):460\u2013469.","DOI":"10.1097\/00004630-199009000-00016"},{"key":"152228","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1097\/00004630-199009000-00016","DOI":"10.1097\/00004630-199009000-00016"},{"key":"152229","doi-asserted-by":"crossref","unstructured":"Xiang F, Song H-P, Huang Y-S. Clinical features and treatment of 140 cases of Marjolin\u2019s ulcer at a major burn center in southwest China. Exp Ther Med. 2019;17(5):3403\u20133410.","DOI":"10.3892\/etm.2019.7364"},{"key":"152230","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.3892\/etm.2019.7364","DOI":"10.3892\/etm.2019.7364"},{"key":"152231","doi-asserted-by":"crossref","unstructured":"Onesti MG, Fino P, Fioramonti P, et al. Ten years of experience in chronic ulcers and malignant transformation. Int Wound J. 2015;12(4):447\u2013450.","DOI":"10.1111\/iwj.12134"},{"key":"152232","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1111\/iwj.12134","DOI":"10.1111\/iwj.12134"},{"key":"152233","doi-asserted-by":"crossref","unstructured":"Bazali\u0144ski D, Przybek-Mita J, Bara\u0144ska B, et al. Marjolin\u2019s ulcer in chronic wounds \u2013 review of available literature. Contemp Oncol (Pozn). 2017;21(3):197\u2013202.","DOI":"10.5114\/wo.2017.70109"},{"key":"152234","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.5114\/wo.2017.70109","DOI":"10.5114\/wo.2017.70109"},{"key":"152235","doi-asserted-by":"crossref","unstructured":"Mitra S, Panda S, Sikka K, et al. Multimodality management of locoregionally extensive Marjolin ulcer: a case report and review of the literature. Wounds. 2024;36(5):166\u2013169.","DOI":"10.25270\/wnds\/23138"},{"key":"152236","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.25270\/wnds\/23138","DOI":"10.25270\/wnds\/23138"},{"key":"152237","unstructured":"Harland DL, Robinson WA, Franklin WA. Deletion of the"},{"key":"152238","doi-asserted-by":"crossref","unstructured":"p53 gene in a patient with aggressive burn scar carcinoma. J Trauma. 1997;42(1):104\u2013107.","DOI":"10.1097\/00005373-199701000-00018"},{"key":"152239","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1097\/00005373-199701000-00018","DOI":"10.1097\/00005373-199701000-00018"},{"key":"152240","doi-asserted-by":"crossref","unstructured":"Hayashi M, Tamura G, Kato N, et al. Genetic analysis of cutaneous squamous cell carcinomas arising from different areas. Pathol Int. 2003;53(9):602\u2013607.","DOI":"10.1046\/j.1440-1827.2003.01523.x"},{"key":"152241","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1046\/j.1440-1827.2003.01523.x","DOI":"10.1046\/j.1440-1827.2003.01523.x"},{"key":"152242","doi-asserted-by":"crossref","unstructured":"Lee SH, Shin MS, Kim HS, et al. Somatic mutations of Fas (Apo-1\/CD95) gene in cutaneous squamous cell carcinoma arising from a burn scar. J Invest Dermatol. 2000;114(1):122\u2013126.","DOI":"10.1046\/j.1523-1747.2000.00819.x"},{"key":"152243","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1046\/j.1523-1747.2000.00819.x","DOI":"10.1046\/j.1523-1747.2000.00819.x"},{"key":"152244","doi-asserted-by":"crossref","unstructured":"Kowal-Vern A, Criswell BK. Burn scar neoplasms: a literature review and statistical analysis. Burns. 2005;31(4):403\u2013413.","DOI":"10.1016\/j.burns.2005.02.015"},{"key":"152245","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.burns.2005.02.015","DOI":"10.1016\/j.burns.2005.02.015"},{"key":"152246","doi-asserted-by":"crossref","unstructured":"Copcu E. Marjolin\u2019s ulcer: a preventable complication of burns? Plast Reconstr Surg. 2009;124(1):156e\u2013164e.","DOI":"10.1097\/PRS.0b013e3181a8082e"},{"key":"152247","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1097\/PRS.0b013e3181a8082e","DOI":"10.1097\/PRS.0b013e3181a8082e"},{"key":"152248","doi-asserted-by":"crossref","unstructured":"Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.","DOI":"10.1136\/bmj.n71"},{"key":"152249","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1136\/bmj.n71","DOI":"10.1136\/bmj.n71"},{"key":"152250","doi-asserted-by":"crossref","unstructured":"Barker TH, Stone JC, Sears K, et al. Revising the JBI quantitative critical appraisal tools to improve their applicability: an overview of methods and the development process. JBI Evid Synth. 2023;21(3):478\u2013493.","DOI":"10.11124\/JBIES-22-00125"},{"key":"152251","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.11124\/JBIES-22-00125","DOI":"10.11124\/JBIES-22-00125"},{"key":"152252","doi-asserted-by":"crossref","unstructured":"Gasparoto TH, de Oliveira CE, de Freitas LT, et al. Inflammatory events during murine squamous cell carcinoma development. J Inflamm (Lond). 2012;9(1):46.","DOI":"10.1186\/1476-9255-9-46"},{"key":"152253","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1186\/1476-9255-9-46","DOI":"10.1186\/1476-9255-9-46"},{"key":"152254","doi-asserted-by":"crossref","unstructured":"Barati M, Akhondi M, Mousavi NS, et al. Pluripotent stem cells: cancer study, therapy, and vaccination. Stem Cell Rev and Rep. 2021;17(6):1975\u20131992.","DOI":"10.1007\/s12015-021-10199-7"},{"key":"152255","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1007\/s12015-021-10199-7","DOI":"10.1007\/s12015-021-10199-7"},{"key":"152256","doi-asserted-by":"crossref","unstructured":"Kim KE, Cho D, Park HJ. Air pollution and skin diseases: adverse effects of airborne particulate matter on various skin diseases. Life Sci. 2016;152:126\u2013134.","DOI":"10.1016\/j.lfs.2016.03.039"},{"key":"152257","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.lfs.2016.03.039","DOI":"10.1016\/j.lfs.2016.03.039"},{"key":"152258","doi-asserted-by":"crossref","unstructured":"Cendrowicz E, Sas Z, Bremer E, et al. The role of macrophages in cancer development and therapy. Cancers (Basel). 2021;13(8):1946.","DOI":"10.3390\/cancers13081946"},{"key":"152259","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.3390\/cancers13081946","DOI":"10.3390\/cancers13081946"},{"key":"152260","doi-asserted-by":"crossref","unstructured":"Stratigos AJ, Garbe C, Dessinioti C, et al. European consensus-based interdisciplinary guideline for invasive cutaneous squamous cell carcinoma. Part 1: diagnostics and prevention-update 2023. Eur J Cancer. 2023;193:113251.","DOI":"10.1016\/j.ejca.2023.113251"},{"key":"152261","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.ejca.2023.113251","DOI":"10.1016\/j.ejca.2023.113251"},{"key":"152262","unstructured":"Squamous cell skin cancer \u2013 Guidelines detail [Internet]. [cited 2025 Jun 27]. Available from: https:\/\/www.nccn.org\/guidelines\/guidelines-detail?category=1&id=1465"},{"key":"152263","doi-asserted-by":"crossref","unstructured":"Keshri VR, Abimbola S, Parveen S, et al. Navigating health systems for burn care: patient journeys and delays in Uttar Pradesh, India. Burns. 2023;49(7):1745\u20131755.","DOI":"10.1016\/j.burns.2023.03.009"},{"key":"152264","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.burns.2023.03.009","DOI":"10.1016\/j.burns.2023.03.009"}],"container-title":["Journal of Plastic Surgery and Hand Surgery"],"original-title":[],"link":[{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/download\/45793\/53646","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/download\/45793\/53646","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T12:35:43Z","timestamp":1776947743000},"score":1,"resource":{"primary":{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/view\/45793"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,23]]},"references-count":42,"URL":"https:\/\/doi.org\/10.2340\/jphs.v61.45793","relation":{},"ISSN":["2000-6764"],"issn-type":[{"value":"2000-6764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,23]]}}}