The Dermatologist’s Role in Long-Term Surveillance of Burn Scars for Malignancy

Chronic burn scars represent a unique dermatologic substrate characterized by persistent inflammation, altered immune surveillance, and long-term structural skin changes that may predispose patients to cutaneous malignancy. Squamous cell carcinoma arising in burn scars, often referred to as Marjolin’s ulcer, is a well-documented but frequently delayed diagnosis associated with aggressive behavior and poor outcomes. While acute burn management is typically overseen by burn specialists and reconstructive surgeons, long-term surveillance of healed burn scars often falls outside structured care pathways. Dermatologists are uniquely positioned to identify early malignant transformation within burn scars due to their expertise in skin cancer recognition and longitudinal outpatient follow-up. This mini-review summarizes the epidemiology and pathophysiology of burn scar–associated malignancy, highlights clinical features suggestive of malignant transformation, and proposes a dermatology-centered framework for surveillance and early intervention. Increased awareness of burn scars as oncogenic risk sites may improve diagnostic timeliness and patient outcomes.