Diagnosis: Skin ulcers
Intractable leg ulcer above the ankle after 42 DeMarco formula treatments.. Clinical photograph sourced from Wikimedia Commons (CC BY-SA 4.0). Attribution: Onthelist.
Venous: shallow, irregular, medial malleolus, surrounding stasis dermatitis and hemosiderosis. Arterial: punched out, painful, lateral malleolus or toes, pallor. Neuropathic: painless, plantar pressure points. PG: rapidly progressive, violaceous undermined borders.
Venous: chronic edema, DVT history, varicose veins. Arterial: claudication, rest pain, smoking, PAD risk factors. Diabetic: peripheral neuropathy, deformity. PG: associated with IBD, hematologic malignancies, rheumatoid arthritis.
Venous: compression therapy (gold standard), wound care, pentoxifylline. Arterial: revascularization referral. Diabetic: offloading, glucose control, wound care. PG: systemic immunosuppression (corticosteroids, cyclosporine), pathergy precautions.
Venous ulcer, Arterial ulcer, Diabetic ulcer, Pyoderma gangrenosum, Vasculitis, Calciphylaxis, Marjolin ulcer (SCC in chronic wound)
ABI (ankle-brachial index) must be checked before compression therapy — contraindicated if ABI <0.5. Pyoderma gangrenosum exhibits pathergy — debridement may worsen it. Chronic non-healing ulcers should be biopsied to exclude malignancy.
Tags: ulcer, wound, chronic, venous, vascular