Ulcer (dermatology)

A detailed overview of ulcers in dermatology

Overview

An ulcer in dermatology refers to a break in the skin or mucous membrane with loss of surface tissue, disintegration and necrosis of epithelial tissue, and often pus. Ulcers can result from a variety of causes, including infection, trauma, and chronic disease. They are characterized by their depth, location, and the underlying cause.

Causes

Ulcers can be caused by several factors, including:

• Infection: Bacterial, viral, or fungal infections can lead to ulcer formation. Common infectious causes include herpes simplex virus and syphilis.
• Chronic disease: Conditions such as diabetes mellitus and peripheral vascular disease can impair healing and lead to ulceration.
• Pressure: Prolonged pressure on the skin, especially in bedridden patients, can cause pressure ulcers.
• Venous insufficiency: Poor venous return can lead to venous ulcers, often seen in the lower extremities.

Types of Ulcers

Ulcers are classified based on their etiology and location:

• Venous ulcers: Typically occur on the lower legs and are associated with chronic venous insufficiency.
• Arterial ulcers: Result from poor arterial blood flow, often seen in patients with atherosclerosis.
• Diabetic ulcers: Common in patients with diabetes, often located on the feet due to neuropathy and poor circulation.
• Pressure ulcers: Also known as bedsores, these occur in areas of prolonged pressure, such as the sacrum and heels.

Diagnosis

The diagnosis of an ulcer involves a thorough medical history and physical examination. Important aspects include:

• Location and size of the ulcer
• Depth and appearance of the ulcer base
• Presence of exudate or necrotic tissue
• Pain and sensation in the affected area

Treatment

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

• Wound care: Regular cleaning and dressing changes to promote healing.
• Antibiotics: If infection is present, appropriate antibiotic therapy is necessary.
• Debridement: Removal of necrotic tissue to promote healing.
• Compression therapy: For venous ulcers, compression stockings or bandages can improve venous return.
• Surgical intervention: In some cases, surgical repair or grafting may be required.

Prevention

Preventive measures are crucial, especially for patients at high risk of ulcer development. These include:

• Regular skin inspection and care
• Maintaining good hygiene and nutrition
• Managing underlying chronic conditions
• Using pressure-relieving devices for immobile patients

Gallery

An example of skin ulceration.

Related pages

• Wound healing
• Dermatology
• Chronic wound
• Pressure ulcer