Leg ulcers

Leg Ulcers

A leg ulcer is a sore or open wound that develops on the skin of the leg, often due to poor circulation or underlying medical conditions. Leg ulcers are a common problem, particularly among older adults, and can be painful and slow to heal. They are classified into different types based on their underlying causes, with the most common being venous, arterial, and diabetic ulcers.

Types of Leg Ulcers

Venous Ulcers

Venous ulcers, also known as stasis ulcers, are the most common type of leg ulcer. They occur due to chronic venous insufficiency, where the veins in the legs fail to return blood efficiently to the heart. This leads to increased pressure in the veins, causing damage to the skin and the formation of ulcers. Venous ulcers typically appear on the inner side of the leg, just above the ankle.

Arterial Ulcers

Arterial ulcers are caused by poor blood flow through the arteries, often due to peripheral artery disease (PAD). These ulcers are usually found on the feet, heels, or toes and are characterized by a "punched-out" appearance. They are often painful, especially at night or when the legs are elevated.

Diabetic Ulcers

Diabetic ulcers are a common complication of diabetes mellitus, particularly in patients with diabetic neuropathy and peripheral vascular disease. These ulcers often occur on the feet and are prone to infection due to reduced sensation and poor circulation.

Causes

The primary causes of leg ulcers include:

• Chronic Venous Insufficiency: Poor functioning of the venous valves leads to blood pooling in the legs.
• Peripheral Artery Disease: Narrowing of the arteries reduces blood flow to the legs.
• Diabetes Mellitus: High blood sugar levels can damage nerves and blood vessels, leading to ulcers.
• Hypertension: High blood pressure can contribute to vascular damage.
• Infections: Bacterial infections can exacerbate ulcer formation and delay healing.

Symptoms

Common symptoms of leg ulcers include:

• Open sores on the leg or foot
• Pain or discomfort in the affected area
• Swelling and redness around the ulcer
• Itching or burning sensation
• Discharge or pus from the ulcer
• Foul odor in case of infection

Diagnosis

Diagnosis of leg ulcers involves a thorough medical history and physical examination. Additional tests may include:

• Doppler Ultrasound: To assess blood flow in the veins and arteries.
• Ankle-Brachial Index (ABI): To evaluate arterial blood flow.
• Blood Tests: To check for underlying conditions such as diabetes or infection.
• Wound Culture: To identify bacterial infections.

Treatment

Treatment of leg ulcers depends on the underlying cause and may include:

• Compression Therapy: Using bandages or stockings to improve venous return.
• Medications: Antibiotics for infections, pain relief, and medications to improve circulation.
• Wound Care: Regular cleaning and dressing of the ulcer to promote healing.
• Surgery: In some cases, surgical intervention may be necessary to improve blood flow or remove dead tissue.

Prevention

Preventive measures for leg ulcers include:

• Maintaining a healthy weight
• Regular exercise to improve circulation
• Controlling blood sugar levels in diabetic patients
• Avoiding smoking and excessive alcohol consumption
• Wearing compression stockings if recommended by a healthcare provider

Also see

• Chronic Venous Insufficiency
• Peripheral Artery Disease
• Diabetic Neuropathy
• Wound Healing
• Compression Therapy