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Causes, investigation and treatment of leg ulceration
Author(s) -
Mekkes J.R.,
Loots M.A.M.,
Van Der Wal A.C.,
Bos J.D.
Publication year - 2003
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1046/j.1365-2133.2003.05222.x
Subject(s) - medicine , pyoderma gangrenosum , vasculitis , diabetes mellitus , population , dermatology , incidence (geometry) , surgery , occlusion , leg ulcer , skin ulcer , chronic venous insufficiency , disease , physics , environmental health , optics , endocrinology
Summary Chronic ulceration of the lower leg is a frequent condition, with a prevalence of 3–5% in the population over 65 years of age. The incidence of ulceration is rising as a result of the ageing population and increased risk factors for atherosclerotic occlusion such as smoking, obesity and diabetes. Ulcers can be defined as wounds with a ‘full thickness depth’ and a ‘slow healing tendency’. In general, the slow healing tendency is not simply explained by depth and size, but caused by an underlying pathogenetic factor that needs to be removed to induce healing. The main causes are venous valve insufficiency, lower extremity arterial disease and diabetes. Less frequent conditions are infection, vasculitis, skin malignancies and ulcerating skin diseases such as pyoderma gangrenosum. But even rarer conditions exist, such as the recently discovered combination of vasculitis and hypercoagulability. For a proper treatment of patients with leg ulcers, it is important to be aware of the large differential diagnosis of leg ulceration.