A patient with a long-standing wound associated with Crohn’s disease is at risk for a scar or wound carcinoma. The malignancies are usually a squamous cell or adenocarcinoma.


Types of wounds that may be affected:

(1) chronic nonhealing wound

(2) fistula opening


Risk factors for carcinoma:

(1) long duration

(2) more intense inflammation

(3) immunosuppression


When to suspect the possibility of a wound carcinoma:

(1) There is a change in the nature of a chronic wound.

(2) The patient has a nonhealing wound that cannot be explained by infection, malnutrition or poor perfusion.

(3) The patient experiences persistent pain.


Examination of the affected area may be limited by pain, induration and/or strictures. Diagnosis often requires persistence and a high level of clinical suspicion.


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