Post burn Marjolin's ulcer in the natal cleft mimicking anal canal carcinoma: a rare site

Marjolin's ulcer is a recognised complication of burn scars, chronic sinuses, and at sites of chronic irritation. The majority of these wounds occur at either venous ulcer or burn sites, usually in the extremities or the trunk. The only current method for confirming diagnosis is biopsy, which if positive will be followed by wide local excision and skin coverage. This paper reports an unusual case, in which a Marjolin's ulcer presented in the natal cleft 45 years after the initial burn injury. Its presentation mimicked that of an anal canal carcinoma, although detailed workup, which included computed tomography (CT) scan revealed this growth to be separate from the anal canal, albeit in close association. This is an extremely rare site and the study illustrates that squamous cell carcinoma can mimic anal carcinoma unless carefully examined.