FREQUENCY OF SQUAMOUS CELL CARCINOMA IN POST BURN PATIENTS

QUA IHSAN; KA KHAN

doi:10.54112/bcsrj.v2024i1.1227

Authors

QUA IHSAN Department of Radiology, Burns and Plastic Surgery Centre MTI Hayatabad Peshawar, Pakistan
KA KHAN Type D hospital Lundkhwar, Mardan, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.1227

Keywords:

Squamous cell carcinoma, post-burn scars, burn injuries, burn severity

Abstract

Burn injuries, particularly those leading to chronic scars, can predispose individuals to the development of squamous cell carcinoma (SCC). The risk of malignant transformation increases with burn severity and long-term scarring. Understanding the prevalence of SCC in post-burn patients is crucial for implementing preventive and management strategies. Objective: To assess the frequency of squamous cell carcinoma (SCC) in patients with post-burn scars and evaluate associations between demographic and burn-related factors with the development of SCC. Methods: A prospective descriptive study was conducted on 70 patients with a history of burn injuries and resulting scars. The study was carried out over a defined period at a tertiary care hospital. Patient demographic variables such as age, gender, socioeconomic background, and education level were collected. The severity of burns was categorized as partial-thickness or full-thickness, and the aetiology of burns was classified as thermal, chemical, or electrical. Burn locations were also documented. Histopathological examination of biopsy specimens from suspicious scars confirmed SCC diagnosis. Statistical analysis using chi-square tests was employed to identify associations between categorical variables and SCC occurrence. Results: Of the 70 patients included, 53 were males (75.7%) and 17 females (24.3%), with a mean age of 53.97 ± 4.91 years. Full-thickness burns were observed in 57.1% of the patients, while 42.9% had partial-thickness burns. The most common burn cause was thermal (45.7%), with the lower extremities being the most affected region (57.1%). SCC developed in 8.6% (6 out of 70) of the patients. The latency period for SCC ranged between 28 and 37 years, with an average of 31.5 years. Full-thickness burns were more commonly associated with SCC development compared to partial-thickness burns. Conclusion: The study reported a frequency of 8.6% for squamous cell carcinoma in patients with post-burn scars. Full-thickness burns were associated with a higher risk of SCC development. Long-term surveillance and proactive management of burn scars are critical in preventing malignant transformations.

Downloads

Download data is not yet available.

References

Johnson DE, Burtness B, Leemans CR, Lui VWY, Bauman JE, Grandis JR. Head and neck squamous cell carcinoma. Nature reviews Disease primers. 2020;6(1):92.

Combalia A, Carrera C. Squamous cell carcinoma: an update on diagnosis and treatment. Dermatology Practical & Conceptual. 2020;10(3).

Tan Y, Wang Z, Xu M, Li B, Huang Z, Qin S, et al. Oral squamous cell carcinomas: state of the field and emerging directions. International journal of oral science. 2023;15(1):44.

Barrett LW, Fear VS, Waithman JC, Wood FM, Fear MW. Understanding acute burn injury as a chronic disease. Burns & trauma. 2019;7.

Huang Y-K, Su Y-J. Burn severity and long-term psychosocial adjustment after burn injury: the mediating role of body image dissatisfaction. Burns. 2021;47(6):1373-80.

Ostojić N, Stepić N, Rajović M, Končar J, Novaković M. Melanoma and squamous cell carcinoma developing on a burn scar. Vojnosanitetski pregled. 2022;79(3):291-5.

Matsui Y, Makino T, Takemoto K, Kagoyama K, Shimizu T. Co-existence of basal cell carcinoma and squamous cell carcinoma in a single burn scar region. Burns Open. 2020;4(2):64-6.

Mousa AK, Elshenawy AA, Maklad SM, Bebars SM, Burezq HA, Sayed SE. Post‐burn scar malignancy: 5‐year management review and experience. International Wound Journal. 2022;19(4):895-909.

Shpichka A, Butnaru D, Bezrukov EA, Sukhanov RB, Atala A, Burdukovskii V, et al. Skin tissue regeneration for burn injury. Stem cell research & therapy. 2019;10:1-16.

Čoma M, Fröhlichová L, Urban L, Zajíček R, Urban T, Szabo P, et al. Molecular changes underlying hypertrophic scarring following burns involve specific deregulations at all wound healing stages (inflammation, proliferation and maturation). International Journal of Molecular Sciences. 2021;22(2):897.

Schwacha MG, Scroggins SR, Montgomery RK, Nicholson SE, Cap AP. Burn injury is associated with an infiltration of the wound site with myeloid-derived suppressor cells. Cellular Immunology. 2019;338:21-6.

Yeon SY, Jung SH, Kim MS, Chung Y-J, Lee SH. Targeted sequencing of burn scar-related squamous cell carcinomas identified PIK3CA amplification. Pathology. 2018;50(5):568-71.

Abdi MA, Yan M, Hanna TP. Systematic review of modern case series of squamous cell cancer arising in a chronic ulcer (Marjolin's ulcer) of the skin. JCO Global Oncology. 2020;6:809-18.

Ozek C, Cankayali R, Bilkay U, Guner U, Gundogan H, Songur E, et al. Marjolin's ulcers arising in burn scars. The Journal of burn care & rehabilitation. 2001;22(6):384-9.

Kowal-Vern A, Criswell BK. Burn scar neoplasms: a literature review and statistical analysis. Burns. 2005;31(4):403-13.

Sharquie KE, Jabbar RI. The Frequency of Squamous Cell Carcinoma Among Patients with Long Standing Burn Scars. Journal of the Turkish Academy of Dermatology. 2021;15(3):65-9.

Gül Ü, Klç A. Squamous cell carcinoma developing on burn scar. Annals of plastic surgery. 2006;56(4):406-8.