Skin cancers and wounds in the geriatric population: a review.

Diagnosis of wound malignancy often remains elusive and is of particular concern in the geriatric population because the average age for presentation of squamous cell cancer is 70 years. Basal and squamous cell carcinoma, as well as Marjolin's ulcer, may look like a chronic or acute wound, can develop in the wound itself, or be found in the scar tissue of these wounds. A complete patient history should include questions about sun exposure and personal and family history of skin cancer. Some wounds exhibit typical clinical signs of cancer - ie, raised borders, crusting - but many do not, making diagnosis more challenging. A punch, excisional, or ellipse biopsy from all ulcers and wounds that do not respond to appropriate protocols of care should be obtained. An accurate diagnosis is crucial to positive treatment outcomes.