Professional Documents
Culture Documents
Definitions
An ulcer is a break in the continuity of an epithelium
Chronic ulcers are those that persist for more than 4 weeks
Specific
TB
Syphilis
Ischemia
Localized destructive
D/s
TB
Gamma
Repeated /Persistent
trauma
Malignancy
Denervation
Peripheral nerve lesions
DM, Nerve injury, Leprosy
History
Duration
Cause
Main
symptom
Course
Pain, Discharge,.
Increasing in size or depth
Became painful (infected?)
Discharging (infected?)
Recurrent (healing & breaking down)
Examination
Site
Shape
Size
Floor
Depth
Edge
Discharge
Skin (or tissues) around
Relations (adherent to deeper tissues)
Draining LNs
Floor
Edge
Examination
Site
Some ulcers have characteristic locations
e.g. Venous ulcer situated in the gaiter area of
the leg
Shape
Size
Are important in follow up of ulcer healing
Examination
Shape
Site
Size
Floor
By inspection you may notice:
Granulation tissue
Sloughs
Gangrenous tissue
Deeper tissues as tendon or bone
Examination
Site
Shape
Size
Floor
Depth
Neuropathic ulcers are deep
Examination
Site
Shape
1- Sloping
Size
Floor
Depth
Edge (5 types)
Examination
Edge (5 types)
1- Sloping
Gamma of 3ry
syphilis
2- Punched-out
Leprosy
Examination
3- Undermined edge
Edge (5 types)
1- Sloping
2- Punched-out
Tuberculous ulcer
Undermined edge in
Pyoderma gangrenosa
Examination
4- Rolled
Edge (5 types)
1- Sloping
2- Punched-out
3- Undermined
Examination
5- Everted edge
Edge (5 types)
1- Sloping
2- Punched-out
3- Undermined
4- Rolled
Malignant transformation in
a chronic venous ulcer
Marjulin ulcer
Examination
Site
Shape
Size
Floor
Depth
Edge
Discharge
May be: serous, sanginous,
serosanguinous or purululent
A dry discharge forms a scab
that covers the ulcer
Examination
Site
Shape
Size
Floor
Depth
Edge
Discharge
Examination
Site
Shape
Size
Floor
Depth
Edge
Discharge
Skin (or tissues) around
Relations (adherent
to deeper tissues)
Examination
Site
Shape
Size
Floor
Depth
Edge
Discharge
Skin (or tissues) around
Relations (adherent to deeper tissues)
Draining LNs