This carcinoma is aggressive in nature, spreads locally and is associated with a poor prognosis.

This malignant change of the wound happens a long time after initial trauma, usually 10–25 years later.

More recent transcriptional analysis suggests that chronically impeded extracellular matrix turnover and epithelium-to-mesenchyme transitions in neglected scar tissue might give rise to this malignancy.

Tissue specimens obtained should be taken from both the centre and margin of lesion, as the central ulcerated deposits may be necrotic.

Treatment is usually surgical, with a wide excision of the lesion; typically a 1 cm margin all around is required.