Florid pseudoepitheliomatous transformation in a chronic pressure ulcer

The case is reported of a florid manifestation of pseudoepitheliomatous hyperplasia in a chronic recurrent right ischial pressure ulcer of 26 years duration in a 60-year-old man with post-traumatic parapereisis. The peculiar characteristics seen were an incidental finding at surgery. Associated left ischial and sacral ulcers did not have these changes. Histological diagnosis of a benign lesion was at variance with a high clinical suspicion of malignant transformation based on the morphological appearance and chronicity. He had ulcer excision and primary flap cover. He was carefully followed up for 4 years and has been without recurrence or disease progression after excision and primary flap cover.