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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