Carcinoma in plantar ulcers of leprosy patients: a report of four cases from Turkey.

Case 1. A 56-year-old male farmer from Kars. Formerly classified as having lepromatous leprosy (LL). The patient was hospitalized due to a chronic plantar ulcer of 3 years duration on his right foot. The biopsy results of the ulcer showed it to be 'epidermoid carcinoma' . Results of a previous biopsy taken at Diyabakir were reported as 'epidermoid carcinoma in primary stage' . The report of further lymph node and lesion biopsies taken on 5 July 1 984 was 'reactive hyperplasia in the lymph node and epidermoid carcinoma in the lesion' . On 1 9 July 1 984 a below-knee (BK) amputation was performed on the patient and a prosthesis was made following the healing of the wound. The patient is presently still alive with no evidence of metastasis . Case 2. A 45-year-old female from Tunceli , classified as having LL. She had a plantar ulcer of 20 years duration from which a biopsy was taken and reported as 'Grade I epidermoid carcinoma' . A BK amputation was performed, a prosthesis fitted and the patient was walking well prior to discharge. One year after discharge, she was re-admitted with a new lesion on the same leg which on biopsy showed 'epidermoid carcinoma' . The patient, who was told that she couldn't benefit from chemoor radiotherapy, died at home. Case 3. A 50-year-old female from Samsun, classified as borderline tuberculoid (BT) leprosy. In December 1 985, this lady was examined in her home and a plantar ulcer on her left foot of 20-years duration was discovered . The basic steps in ulcer care were explained to her. In March 1 986, she was admitted to hospital with a 'cauliflower-like' growth on the plantar ulcer site and enlarged groin lymph glands. Lesion and nobe biopsies revealed epidermoid carcinoma. Her condition gradually deteriorated and a few months later she died. Case 4. A 53-year-old male, farmer from K. Maras, classified as BT. In May 1 986, this patient was seen in his home with a chronic plantar ulcer. In April 1 987, he was admitted to hospital with a 'cauliflower-like' growth on the ulcer. Biopsy results showed epidermoid carcinoma. On 7 May 1 987, a BK amputation was performed, later a prosthesis was fitted . This patient is doing well to date following the BK amputation.