Leg ulcer: Difference between revisions

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__NOTOC__
{{Infobox_Disease |
{{Infobox_Disease |
   Name          = {{PAGENAME}} |
   Name          = {{PAGENAME}} |
   Image          = Leg ulcer 001.jpg|
   Image          = Leg ulcer 001.jpg|
   Caption        = Disseminated Intravascular Coagulation: Gross view of thighs and legs at autopsy ecchymoses with central necrosis and ulceration looks like [[pyoderma gangrenosum]]. <br> <small> [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology] </small>|
   Caption        = Disseminated Intravascular Coagulation: Gross view of thighs and legs at autopsy ecchymoses with central necrosis and ulceration looks like [[pyoderma gangrenosum]]. <br> <small> [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology] </small>|}}
  DiseasesDB    = |
  ICD10          = |
  ICD9          = |
  ICDO          = |
  OMIM          = |
  MedlinePlus    = |
  eMedicineSubj  = |
  eMedicineTopic = |
  MeshID        = |
}}
{{SI}}
{{SI}}
{{CMG}}; {{VR}}
{{CMG}}; {{AE}} {{VR}}
__NOTOC__
 
==Overview==
==Overview==
'''Leg ulcer'''s usually refer to ulcers of the lower leg. The most common cause of leg ulcers is [[venous insufficiency]].  
Leg ulcers usually refer to ulcers of the lower leg. The most common cause of leg ulcers is [[venous insufficiency]].
==Causes<ref>{{Cite web  | last =  | first = | title = Differential diagnosis of leg ulcers - Dissemond - 2006 - JDDG: Journal der Deutschen Dermatologischen Gesellschaft - Wiley Online Library | url = http://onlinelibrary.wiley.com/doi/10.1111/j.1610-0387.2006.06052.x/abstract | publisher = | date = | accessdate = 12 July 2013 }}</ref><ref>{{Cite web  | last = | first = | title = http://www.health.wa.gov.au/woundswest/docs/WPR_Nov09_Atypical_Leg_Ulcers.pdf | url = http://www.health.wa.gov.au/woundswest/docs/WPR_Nov09_Atypical_Leg_Ulcers.pdf | publisher =  | date =  | accessdate = 12 July 2013 }}</ref>==
 
==Causes==
===Life Threatening Causes===
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
 
*[[Aneurysm]]
*[[Arterial thrombosis]]
*[[Blood clot]]
*[[Burns]]
*[[Cholesterol embolism]]
*[[Immersion foot|Cold injury]]
*[[Deep vein thrombosis]]
*[[Gas gangrene]]
*[[Osteomyelitis]]


===Common Causes===
===Common Causes===
*[[Basal Cell Carcinoma]]
*[[Basal Cell Carcinoma]]
*Chronic [[venous insufficiency]]
*[[Decubitus ulcer]]
*[[Decubitus ulcer]]
*[[Deep vein thrombosis]]
*[[Deep vein thrombosis]]
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*[[Squamous cell carcinoma]]
*[[Squamous cell carcinoma]]
*[[Thromboangiitis obliterans]]
*[[Thromboangiitis obliterans]]
*[[Vasculitis]]
*[[Venous insufficiency]]
*[[Vasculitis]]<ref>{{Cite web  | last =  | first =  | title = Differential diagnosis of leg ulcers - Dissemond - 2006 - JDDG: Journal der Deutschen Dermatologischen Gesellschaft - Wiley Online Library | url = http://onlinelibrary.wiley.com/doi/10.1111/j.1610-0387.2006.06052.x/abstract | publisher =  | date =  | accessdate = 12 July 2013 }}</ref><ref>{{Cite web  | last =  | first =  | title = http://www.health.wa.gov.au/woundswest/docs/WPR_Nov09_Atypical_Leg_Ulcers.pdf | url = http://www.health.wa.gov.au/woundswest/docs/WPR_Nov09_Atypical_Leg_Ulcers.pdf | publisher =  | date =  | accessdate = 12 July 2013 }}</ref>


===Causes by Organ System===
===Causes by Organ System===
{|style="width:82%; height:100px" border="1"
{|style="width:82%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Allergic vasculitis]], [[Anemia]], [[Aneurysm]], [[Angiosarcoma]], [[Arterial dysplasia]],  [[Arterial insufficiency]], [[Arterial thrombosis]], [[Arterio-venous malformation]], [[Arteriovenous fistulas]], [[Arteriovenous malformation]], [[Atheroma]], [[Atherosclerosis]], [[Cholesterol embolism]], [[Chronic venous insufficiency]], [[Churg-strauss syndrome]], [[Congestive heart failure]], [[Deep vein thrombosis ]], [[Dehydration]], [[Diabetes mellitus]], [[Embolism]], [[Heart failure]], [[Hypertension]], [[Hypotension]], [[Hypothermia]], [[Kaposi's sarcoma]], [[Leukocytoclastic vasculitis]], [[Livedoid vasculopathy]], [[Lymphangitis]], [[Lymphatic obstruction]], [[Lymphatic vessel dysplasia]], [[Lymphedema]], [[Peripheral artery disease]], [[Polyarteritis nodosa]], [[Polyarteritis]], [[Postthrombotic syndrome]], [[Raynaud's syndrome]], [[Sepsis ]], [[Septic emboli]], [[Thromboangiitis obliterans]], [[Thrombotic thrombocytopenic purpura]], [[Varicose veins]], [[Vasculitis]], [[Venous dysplasia]], [[Wegener's granulomatosis]]
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Allergic vasculitis]], [[anemia]], [[aneurysm]], [[angiosarcoma]], [[arterial insufficiency]], [[arterial thrombosis]], [[arterio-venous malformation]], [[arteriovenous fistula]], [[arteriovenous malformation]], [[atheroma]], [[atherosclerosis]], [[cholesterol embolism]], [[venous insufficiency]], [[Churg-Strauss syndrome]], [[congestive heart failure]], [[deep vein thrombosis]], [[Degos disease]], [[dehydration]], [[diabetes mellitus]], [[embolism]], [[fibromuscular dysplasia]], [[heart failure]], [[hypertension]], [[hypotension]], [[hypothermia]], [[kaposi's sarcoma]], [[leukocytoclastic vasculitis]], [[livedoid vasculopathy]], [[lymphangitis]], [[lymphatic obstruction]], [[Lymphedema|lymphatic vessel dysplasia]], [[lymphedema]], [[Degos disease|papulosis maligna atrophicans]], [[peripheral artery disease]], [[polyarteritis nodosa]], [[polyarteritis]], [[post-thrombotic syndrome]], [[Raynaud's syndrome]], [[sepsis]], [[septic emboli]], [[thromboangiitis obliterans]], [[thrombotic thrombocytopenic purpura]], [[varicose veins]], [[vasculitis]], [[Chronic Venous insufficiency|venous valvular incompetence]], [[Wegener's granulomatosis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Chemical/Poisoning'''
| '''Chemical/Poisoning'''
|bgcolor="Beige"| [[Arsenic]], [[Erythema induratum of bazin]]
|bgcolor="Beige"| [[Arsenic]], [[Spider bite|spider bites]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
| '''Dermatologic'''
|bgcolor="Beige"| [[Actinic keratosis]], [[Advanced age]], [[Allergic vasculitis]], [[Amoebiasis cutis]], [[Contact dermatitis]], [[Continuous trauma]], [[Crohn's disease]], [[Decubitus ulcer]], [[Ecthyma]], [[Erysipelas]], [[Erythema induratum of bazin]], [[Filariasis]], [[Furuncle]], [[Glanders]], [[Herpes simplex]], [[Incontinence]],  [[Keratoacanthoma]], [[Lymphoma ulcers]],  [[Madura foot]], [[Melanoma]],  [[Perforating dermatosis ]], [[Porphyria cutanea tarda]], [[Prolonged Immobilization]], [[Radiation dermatitis]], [[Sporotrichosis]], [[Squamous cell carcinoma ]], [[Ulcerative colitis]], [[Xeroderma pigmentosum]]  
|bgcolor="Beige"| [[Acquired perforating dermatosis]], [[actinic keratosis]], [[advanced age]], [[allergic vasculitis]], [[Amoebiasis|amebiasis cutis]], [[contact dermatitis]], [[Skin trauma|continuous trauma]], [[Crohn's disease]], [[Lymphoma|cutaneous lymphoma ulcers]], [[decubitus ulcer]], [[Ecthyma gangrenosum | ecthyma]], [[erysipelas]], [[Bazin disease | erythema induratum of bazin]], [[filariasis]], [[furuncle]], [[glanders]], [[herpes simplex]], [[keratoacanthoma]], [[Eumycetoma | madura foot]], [[melanoma]], [[porphyria cutanea tarda]], [[Bedsore|prolonged immobilization]], [[radiodermatitis]], [[sporotrichosis]], [[squamous cell carcinoma]], [[ulcerative colitis]], [[xeroderma pigmentosum]]  
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Coumarin]], [[Ergotamine]], [[Extravasated cytostatic agents]], [[Fibrinolysis factors (t-PA, PAI, Plasmin)]], [[Halogens]], [[Hydroxyurea]], [[Leflunomide]], [[Methotrexate]], [[Penicillin]]
|bgcolor="Beige"| [[Coumarin]], [[ergotamine]], [[Chemotherapy | cytostatic agents]], [[halogens]], [[hydroxyurea]], [[leflunomide]], [[methotrexate]], [[penicillin]], [[plasmin]], [[plasminogen activator inhibitor-1]], [[tissue plasminogen activator]]  
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
| '''Endocrine'''
|bgcolor="Beige"| [[Diabetes mellitus]], [[Necrobiosis lipoidica]]
|bgcolor="Beige"| [[Diabetes mellitus]], [[necrobiosis lipoidica]]
|-  
|-  
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Environmental'''
| '''Environmental'''
|bgcolor="Beige"| [[Burns]], [[Cold injury]], [[Contact dermatitis]], [[Heat]], [[Ionizing radiation]], [[Noxious chemicals]],  [[Radiation dermatitis]]
|bgcolor="Beige"| [[Burns]], [[Immersion foot|cold injury]], [[contact dermatitis]], [[heat]], [[ionizing radiation]], [[radiodermatitis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| '''Gastroenterologic'''
|bgcolor="Beige"| [[Crohn's disease]], [[Incontinence]],  [[Ulcerative colitis]]
|bgcolor="Beige"| [[Crohn's disease]], [[ulcerative colitis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
|bgcolor="Beige"| [[Arterial dysplasia]], [[Factor V Leiden mutation]], [[Gaucher's disease]], [[Hereditary spherocytosis]], [[Klinefelter syndrome]], [[Leukocyte adhesion deficiency]], [[Lymphatic vessel dysplasia]], [[Prolidase deficiency]], [[Thalassaemia]], [[Venous dysplasia]], [[Xeroderma pigmentosum]]  
|bgcolor="Beige"| [[Fibromuscular dysplasia]], [[factor V Leiden mutation]], [[Gaucher's disease]], [[hereditary spherocytosis]], [[Klinefelter syndrome]], [[leukocyte adhesion deficiency]], [[Lymphedema|lymphatic vessel dysplasia]], [[prolidase deficiency]], [[Leprosy|tap1 mutation]], [[thalassaemia]], [[xeroderma pigmentosum]]  
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
| '''Hematologic'''
|bgcolor="Beige"| [[Anemia]], [[antiphospholipid syndrome]], [[antithrombin III deficiency]], [[Blood clot]], [[Coumarin]],  [[Cryoglobulinemia]], [[Deep vein thrombosis ]], [[dysproteinaemia]], [[Essential thrombocythemia]], [[Factor V Leiden mutation]], [[Factor XIII deficiency]], [[Felty's syndrome]], [[Fibrinolysis factors (t-PA, PAI, Plasmin)]],  [[granulocytopenia]], [[hereditary spherocytosis]], [[Langerhans cell histiocytosis]], [[Leukemia]], [[Leukocyte adhesion deficiency]], [[lupus anticoagulant]], [[Macroglobulinemia]], [[Myelodysplasia]], [[Plasma coagulation inhibitors (antithrombinviii, apc resistance, protein c and s)]], [[polyclonal dysproteinaemia]], [[polycythemia ]], [[Polycythemia vera]], [[Primary polycythemia]], [[primary thrombocythemia]], [[Protein c deficiency]], [[Protein s deficiency]], [[purpura]], [[Sickle cell anemia]], [[Thalassemia]], [[thrombotic thrombocytopenic ]]
|bgcolor="Beige"| [[Activated protein C resistance]], [[anemia]], [[antiphospholipid syndrome]], [[antithrombin III deficiency]], [[blood clot]], [[cryoglobulinemia]], [[deep vein thrombosis ]], [[dysproteinemia]], [[essential thrombocythemia]], [[factor V Leiden mutation]], [[factor XIII deficiency]], [[Felty's syndrome]], [[granulocytopenia]], [[hereditary spherocytosis]], [[Langerhans cell histiocytosis]], [[leukemia]], [[leukocyte adhesion deficiency]], [[lupus anticoagulant]], [[macroglobulinemia]], [[myelodysplasia]], [[plasmin]], [[plasminogen activator inhibitor-1]], [[Dysproteinemia|polyclonal dysproteinemia]], [[polycythemia]], [[polycythemia vera]], [[Polycythemia vera | primary polycythemia]], [[primary thrombocythemia]], [[protein C deficiency]], [[protein S deficiency]], [[purpura]], [[sickle cell anemia]], [[thalassemia]], [[thrombotic thrombocytopenic purpura]],[[tissue plasminogen activator]] 
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| '''Iatrogenic'''
|bgcolor="Beige"| [[Calcinosis cutis]], [[Extravasated cytostatic agents]], [[Radiation dermatitis]],  [[Vaccinations]]
|bgcolor="Beige"| [[Calcinosis cutis]], [[Chemotherapy | cytostatic agents]], [[radiodermatitis]],  [[vaccinations]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"| [[Actinomycosis]], [[Amoebiasis cutis]], [[Amoebiasis]], [[Anthrax]], [[Bacillary angiomatosis]], [[Bacterial infection]], [[Bacteroides]], [[Blastomycosis]], [[Borrelia vincenti]], [[Cellulitis]], [[Coccidiomycosis]], [[Cold agglutinin disease]], [[Diphtheria]], [[Ecthyma gangrenosum ]], [[Ecthyma]],  [[Erysipelas]], [[Fasciitis necroticans ]], [[Filariasis]], [[Folliculitis]], [[Franciscella tularensis]], [[Furuncle]], [[Gas gangrene ]], [[Glanders]], [[Granuloma inguinale]], [[hemophilus ducreyi]], [[Herpes simplex]], [[Histoplasmosis]], [[Kala-azar]], [[Leishmaniasis]], [[Leprosy]], [[Lues maligna]], [[Lymphangitis]], [[Madura foot]], [[Mycobacterium ulcerans]], [[Mycosis fungoides]], [[Osteomyelitis]], [[Papillomatosis cutis carcinoides]], [[Poliomyelitis]], [[Rodent ulcer]], [[Sepsis ]], [[Septic emboli]], [[Sporotrichosis]], [[Syphilis]], [[Tinea pedis]], [[Tropical ulcer]],  [[Tuberculosis]], [[Tularemia]], [[Ulceration pyoderma ]],  [[Variola virus]], [[Vasculitis]], [[Yaws]]
|bgcolor="Beige"| [[Actinomycosis]], [[Amoebiasis|amoebiasis cutis]], [[amoebiasis]], [[anthrax]], [[bacillary angiomatosis]], [[bacterial infection]], [[bacteroides]], [[blastomycosis]], [[Borrelia|borrelia vincenti]], [[cellulitis]], [[coccidiomycosis]], [[cold agglutinin disease]], [[diphtheria]], [[ecthyma gangrenosum | ecthyma]], [[ecthyma gangrenosum]], [[Impetigo | ecthyma]],  [[erysipelas]], [[fasciitis necroticans]], [[filariasis]], [[folliculitis]], [[francisella tularensis]], [[furuncle]], [[gas gangrene]], [[glanders]], [[granuloma inguinale]], [[haemophilus ducreyi]], [[herpes simplex]], [[histoplasmosis]], [[kala-azar]], [[leishmaniasis]], [[leprosy]], [[Syphilis | lues maligna]], [[lymphangitis]], [[Eumycetoma | madura foot]], [[mycobacterium ulcerans]], [[mycosis fungoides]], [[osteomyelitis]], [[Human papillomavirus|papillomatosis cutis carcinoides]], [[poliomyelitis]], [[rodent ulcer]], [[sepsis]], [[septic emboli]], [[sporotrichosis]], [[syphilis]], [[tinea pedis]], [[Cutaneous leishmaniasis|tropical ulcer]],  [[tuberculosis]], [[tularemia]], [[variola virus]], [[vasculitis]], [[yaws]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| [[Badly united fracture]], [[Lower limb fractures]]
|bgcolor="Beige"| [[bone fractures|Badly united fractures]], [[bone fractures]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
| '''Neurologic'''
|bgcolor="Beige"| [[Alcoholic neuropathy]], [[Autonomic dysfunction]], [[Dementia]], [[Diabetic neuropathy]], [[Hemiplegia]], [[Infantile palsy]], [[Multiple sclerosis]], [[Neuropathy]], [[Spina bifida]], [[Spinal cord injury]], [[Spinal cord lesions]], [[Syringomyelia]]
|bgcolor="Beige"| [[Alcoholic neuropathy]], [[autonomic dysfunction]], [[cerebral palsy]], [[dementia]], [[diabetic neuropathy]], [[hemiplegia]], [[multiple sclerosis]], [[neuropathy]], [[spina bifida]], [[spinal cord injury]], [[spinal cord lesions]], [[syringomyelia]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| [[Calcinosis cutis]], [[Calciphylaxis]], [[Gout]], [[Hyperhomocysteinemia]], [[Malnutrition]], [[Necrobiosis lipoidica]], [[Porphyria cutanea tarda]], [[Starvation]]
|bgcolor="Beige"| [[Calcinosis cutis]], [[calciphylaxis]], [[gout]], [[hyperhomocysteinemia]], [[malnutrition]], [[necrobiosis lipoidica]], [[porphyria cutanea tarda]],[[starvation]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"| [[Angiosarcoma]], [[Basal cell carcinoma]], [[Cold agglutinin disease]], [[Cutaneous lymphoma]], [[Leukemia]],  [[Lymphoma ulcers]], [[Macroglobulinemia]], [[Marjolin's ulcer]], [[Melanoma]],  [[Metastatic tumours]], [[Sarcoma]], [[Squamous cell carcinoma ]]
|bgcolor="Beige"| [[Angiosarcoma]], [[basal cell carcinoma]], [[cold agglutinin disease]], [[Lymphoma|cutaneous lymphoma ulcers]], [[leukemia]], [[macroglobulinemia]], [[Marjolin's ulcer]], [[melanoma]], [[sarcoma]], [[squamous cell carcinoma]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
| '''Psychiatric'''
|bgcolor="Beige"| [[Delirium]]
|bgcolor="Beige"| [[Delirium]], [[Factitious disorder|factitious ulceration]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
| '''Renal/Electrolyte'''
|bgcolor="Beige"| [[Calciphylaxis]],  [[Incontinence]]
|bgcolor="Beige"| [[Calciphylaxis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Rheumatoid arthritis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Trauma'''
| '''Trauma'''
|bgcolor="Beige"| [[Continuous trauma]], [[Lower limb fractures]], [[Lower limb nerve injury]], [[Marjolin's ulcer]], [[Shearing forces]], [[Spinal cord injury]]
|bgcolor="Beige"| [[Skin trauma|Continuous trauma]], [[bone fractures]], [[Sciatica|lower limb nerve injury]], [[Marjolin's ulcer]], [[Physical trauma|shearing forces]], [[spinal cord injury]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| '''Miscellaneous'''
|bgcolor="Beige"| [[Amyloidosis]], [[Artefacts]],  [[Decubitus ulcer]], [[Factitious ulceration]],  [[Friction]], [[Low weight]], [[Marjolin's ulcer]], [[Moisture in the form of perspiration, feces, or urine]],  [[Papulosis maligna atrophicans]],  [[Prolonged Immobilization]],  [[Sarcoidosis]], [[Spider bites]]
|bgcolor="Beige"| [[Amyloidosis]], [[decubitus ulcer]], [[friction]], [[underweight|low weight]], [[Marjolin's ulcer]], [[Bedsore|prolonged immobilization]], [[sarcoidosis]]
|-
|-
|}
|}
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{{col-begin|width=85%}}
{{col-begin|width=85%}}
{{col-break|width=33%}}
{{col-break|width=33%}}
*[[Acquired perforating dermatosis]]
*[[Actinic keratosis]]
*[[Actinic keratosis]]
*[[Actinomycosis]]
*[[Actinomycosis]]
Line 157: Line 162:
*[[Alcoholic neuropathy]]
*[[Alcoholic neuropathy]]
*[[Allergic vasculitis]]
*[[Allergic vasculitis]]
*[[Amoebiasis cutis]]
*[[Amoebiasis|Amoebiasis cutis]]
*[[Amoebiasis]]
*[[Amoebiasis]]
*[[Amyloidosis]]
*[[Amyloidosis]]
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*[[Angiosarcoma]]
*[[Angiosarcoma]]
*[[Anthrax]]
*[[Anthrax]]
*[[antiphospholipid syndrome]]
*[[Antiphospholipid syndrome]]
*[[antithrombin III deficiency]]
*[[Antithrombin III deficiency]]
*[[Arsenic]]
*[[Arsenic]]
*[[Artefacts]]
*[[Arterial dysplasia]]
*[[Arterial insufficiency]]
*[[Arterial insufficiency]]
*[[Arterial thrombosis]]
*[[Arterial thrombosis]]
*[[Arterio-venous malformation]]
*[[Arterio-venous malformation]]
*[[Arteriovenous fistulas]]
*[[Arteriovenous fistula]]
*[[Arteriovenous malformation]]
*[[Atheroma]]
*[[Atheroma]]
*[[Atherosclerosis]]
*[[Atherosclerosis]]
Line 180: Line 182:
*[[Bacterial infection]]
*[[Bacterial infection]]
*[[Bacteroides]]
*[[Bacteroides]]
*[[Badly united fracture]]
*[[bone fractures|Badly united fracture]]
*[[Basal cell carcinoma]]
*[[Basal cell carcinoma]]
*[[Behcet disease ]]
*[[Behcet disease ]]
*[[Blastomycosis]]
*[[Blastomycosis]]
*[[Blood clot]]
*[[Blood clot]]
*[[Borrelia vincenti]]
*[[Bone fractures]]
*[[Borrelia|Borrelia vincenti]]
*[[Bullous pemphigoid]]
*[[Bullous pemphigoid]]
*[[Burns]]
*[[Burns]]
Line 191: Line 194:
*[[Calciphylaxis]]
*[[Calciphylaxis]]
*[[Cellulitis]]
*[[Cellulitis]]
*[[Cerebral palsy]]
*[[Cholesterol embolism]]
*[[Cholesterol embolism]]
*[[Chronic venous insufficiency]]
*[[Churg-Strauss syndrome]]
*[[Chronically injured or diseased skin]]
*[[Churg-strauss syndrome]]
*[[Coccidiomycosis]]
*[[Coccidiomycosis]]
*[[Cold agglutinin disease]]
*[[Cold agglutinin disease]]
*[[Cold injury]]
*[[Immersion foot|Cold injury]]
*[[Congestive heart failure]]
*[[Congestive heart failure]]
*[[Contact dermatitis]]
*[[Contact dermatitis]]
*[[Continuous trauma]]
*[[Skin trauma|Continuous trauma]]
*[[Coumarin]]
*[[Coumarin]]
*[[Crohn's disease]]
*[[Crohn's disease]]
*[[Cryoglobulinemia]]
*[[Cryoglobulinemia]]
*[[Cutaneous lymphoma]]
*[[Lymphoma|Cutaneous lymphoma ulcers]]
*[[Decubitus ulcer]]
*[[Decubitus ulcer]]
*[[Deep vein thrombosis ]]
*[[Deep vein thrombosis]]
* [[Degos disease]]
*[[Dehydration]]
*[[Dehydration]]
*[[Delirium]]
*[[Delirium]]
Line 213: Line 216:
*[[Diabetic neuropathy]]
*[[Diabetic neuropathy]]
*[[Diphtheria]]
*[[Diphtheria]]
*[[dysproteinaemia]]
*[[Dysproteinemia]]
*[[Ecthyma gangrenosum]]
*[[Ecthyma gangrenosum]]
*[[Ecthyma]]
*[[Ecthyma gangrenosum | Ecthyma]]
*[[Embolism]]
*[[Embolism]]
*[[Ergotamine]]
*[[Ergotamine]]
*[[Erysipelas]]
*[[Erysipelas]]
*[[Erythema induratum of bazin]]
*[[Bazin disease | Erythema induratum of bazin]]
{{col-break|width=33%}}
*[[Essential thrombocythemia]]
*[[Essential thrombocythemia]]
{{col-break|width=33%}}
*[[Chemotherapy | Extravasated cytostatic agents]]
*[[Extravasated cytostatic agents]]
*[[Factitious disorder|Factitious ulceration]]
 
*[[Factitious ulceration]]
*[[Factor V Leiden mutation]]
*[[Factor V Leiden mutation]]
*[[Factor XIII deficiency]]
*[[Factor XIII deficiency]]
*[[Fasciitis necroticans ]]
*[[Fasciitis necroticans ]]
*[[Felty's syndrome]]
*[[Felty's syndrome]]
*[[Fibrinolysis factors (t-PA, PAI, Plasmin)]]
*[[Fibromuscular dysplasia]]
*[[Filariasis]]
*[[Filariasis]]
*[[Folliculitis]]
*[[Folliculitis]]
*[[Franciscella tularensis]]
*[[Francisella tularensis]]
*[[Friction]]
*[[Friction]]
*[[Furuncle]]
*[[Furuncle]]
*[[Gas gangrene ]]
*[[Gas gangrene]]
*[[Gaucher's disease]]
*[[Gaucher's disease]]
*[[Glanders]]
*[[Glanders]]
*[[Gout]]
*[[Gout]]
*[[granulocytopenia]]
*[[Granulocytopenia]]
*[[Granuloma inguinale]]
*[[Granuloma inguinale]]
*[[Halogens]]
*[[Halogens]]
Line 245: Line 247:
*[[Heat]]
*[[Heat]]
*[[Hemiplegia]]
*[[Hemiplegia]]
*[[hemophilus ducreyi]]
*[[Haemophilus ducreyi]]
*[[Hereditary spherocytosis]]
*[[Hereditary spherocytosis]]
*[[Herpes simplex]]
*[[Herpes simplex]]
Line 254: Line 256:
*[[Hypotension]]
*[[Hypotension]]
*[[Hypothermia]]
*[[Hypothermia]]
*[[Incontinence]]
*[[Infantile palsy]]
*[[Ionizing radiation]]
*[[Ionizing radiation]]
*[[Kala-azar]]
*[[Kala-azar]]
Line 261: Line 261:
*[[Keratoacanthoma]]
*[[Keratoacanthoma]]
*[[Klinefelter syndrome]]
*[[Klinefelter syndrome]]
*[[Lack of exercise]]
*[[Obesity|Lack of exercise]]
*[[Langerhans cell histiocytosis]]
*[[Langerhans cell histiocytosis]]
*[[Leflunomide]]
*[[Leflunomide]]
Line 270: Line 270:
*[[Leukocytoclastic vasculitis]]
*[[Leukocytoclastic vasculitis]]
*[[Livedoid vasculopathy]]
*[[Livedoid vasculopathy]]
*[[Low weight]]
*[[Underweight|Low weight]]
*[[Lower limb fractures]]
*[[Sciatica|Lower limb nerve injury]]
*[[Lower limb nerve injury]]
*[[Syphilis | Lues maligna]]
*[[Lues maligna]]
*[[Lupus anticoagulant]]
*[[lupus anticoagulant]]
*[[Lupus erythematosus]]
*[[Lupus erythematosus]]
*[[Lymphangitis]]
*[[Lymphangitis]]
*[[Lymphatic obstruction]]
*[[Lymphatic obstruction]]
*[[Lymphatic vessel dysplasia]]
*[[Lymphedema|Lymphatic vessel dysplasia]]
*[[Lymphedema]]
*[[Lymphedema]]
*[[Lymphoma ulcers]]
*[[Macroglobulinemia]]
*[[Macroglobulinemia]]
*[[Madura foot]]
*[[Eumycetoma | Madura foot]]
*[[Malnutrition]]
*[[Malnutrition]]
*[[Marjolin's ulcer]]
*[[Marjolin's ulcer]]
*[[Melanoma]]
*[[Melanoma]]
*[[Metastatic tumours]]
*[[Methotrexate]]
*[[Methotrexate]]
*[[Moisture in the form of perspiration, feces, or urine]]
*[[Multiple sclerosis]]
*[[Multiple sclerosis]]
*[[Mycobacterium ulcerans]]
*[[Mycobacterium ulcerans]]
*[[Mycosis fungoides]]
*[[Mycosis fungoides]]
{{col-break|width=33%}}
*[[Myelodysplasia]]
*[[Myelodysplasia]]
*[[Necrobiosis lipoidica]]
*[[Necrobiosis lipoidica]]
*[[Neuropathy]]
*[[Neuropathy]]
*[[Noxious chemicals]]
*[[Osteomyelitis]]
*[[Osteomyelitis]]
*[[Papillomatosis cutis carcinoides]]
{{col-break|width=33%}}
*[[Papulosis maligna atrophicans]]
*[[Human papillomavirus|Papillomatosis cutis carcinoides]]
*[[Degos disease|Papulosis maligna atrophicans]]
*[[Pemphigus vulgaris]]
*[[Pemphigus vulgaris]]
*[[Penicillin]]
*[[Penicillin]]
*[[Perforating dermatosis ]]
*[[Peripheral artery disease]]
*[[Peripheral artery disease]]
*[[Phlebitis]]
*[[Phlebitis]]
*[[Plasmin]]
*[[Plasminogen activator inhibitor-1]]
*[[Poliomyelitis]]
*[[Poliomyelitis]]
*[[Polyarteritis nodosa]]
*[[Polyarteritis nodosa]]
*[[Polyarteritis]]
*[[Polyarteritis]]
*[[polyclonal dysproteinaemia]]
*[[Dysproteinemia|Polyclonal dysproteinemia]]
*[[Polycythemia vera]]
*[[Polycythemia vera]]
*[[Porphyria cutanea tarda]]
*[[Porphyria cutanea tarda]]
*[[Postthrombotic syndrome]]
*[[Post-thrombotic syndrome]]
*[[Primary polycythemia]]
*[[Polycythemia vera |Primary polycythemia]]
*[[primary thrombocythemia]]
*[[Primary thrombocythemia]]
*[[Prolidase deficiency]]
*[[Prolidase deficiency]]
*[[Prolonged Immobilization]]
*[[Bedsore|Prolonged immobilization]]
*[[Protein c deficiency]]
*[[Protein C deficiency]]
*[[Protein s deficiency]]
*[[Protein S deficiency]]
*[[purpura]]
*[[Purpura]]
*[[Pyoderma gangrenosum]]
*[[Pyoderma gangrenosum]]
*[[Radiation dermatitis]]
*[[Radiodermatitis]]
*[[Raynaud's syndrome]]
*[[Raynaud's syndrome]]
*[[Rheumatoid ulcers]]
*[[Rheumatoid arthritis]]
*[[Rodent ulcer]]
*[[Rodent ulcer]]
*[[Sarcoidosis]]
*[[Sarcoidosis]]
Line 330: Line 325:
*[[Sepsis ]]
*[[Sepsis ]]
*[[Septic emboli]]
*[[Septic emboli]]
*[[Shearing forces]]
*[[Physical trauma|Shearing forces]]
*[[Sickle cell anemia]]
*[[Sickle cell anemia]]
*[[Sjogren syndrome]]
*[[Sjogren syndrome]]
*[[Smoking]]
*[[Smoking]]
*[[Spider bites]]
*[[Spider bite|Spider bites]]
*[[Spina bifida]]
*[[Spina bifida]]
*[[Spinal cord injury]]
*[[Spinal cord injury]]
Line 344: Line 339:
*[[Syringomyelia]]
*[[Syringomyelia]]
*[[Systemic lupus erythematosus]]
*[[Systemic lupus erythematosus]]
*[[Tap1 mutation]]
*[[Leprosy|Tap1 mutation]]
*[[Thalassemia]]
*[[Thalassemia]]
*[[Thromboangiitis obliterans]]
*[[Thromboangiitis obliterans]]
*[[Thrombotic thrombocytopenic purpura]]
*[[Thrombotic thrombocytopenic purpura]]
*[[Tinea pedis]]
*[[Tinea pedis]]
*[[Tropical ulcer]]
*[[Tissue plasminogen activator]]
*[[Cutaneous leishmaniasis|Tropical ulcer]]
*[[Tuberculosis]]
*[[Tuberculosis]]
*[[Tularemia]]
*[[Tularemia]]
*[[Ulceration pyoderma ]]
*[[Impetigo|Ulcerative pyoderma]]
*[[Ulcerative colitis]]
*[[Ulcerative colitis]]
*[[Vaccinations]]
*[[Vaccinations]]
Line 358: Line 354:
*[[Variola virus]]
*[[Variola virus]]
*[[Vasculitis]]
*[[Vasculitis]]
*[[Venous dysplasia]]
*[[Venous insufficiency]]
*[[Venous valvular incompetence]]
*[[Chronic Venous insufficiency|Venous valvular incompetence]]
*[[Wegener's granulomatosis]]
*[[Wegener's granulomatosis]]
*[[Xeroderma pigmentosum]]
*[[Xeroderma pigmentosum]]
*[[Yaws]]
*[[Yaws]]
{{col-end}}
{{col-end}}
== Differential diagnosis of leg ulcer<ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref><ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>==
* [[Anemia]]
* [[Arteriosclerosis]]
* [[Arteriovenous malformation]]
* [[Basal cell carcinoma]]
* [[Blastomycosis]]
* Bullous Disease
* [[Buerger's disease]]
* [[Burn]]s
* [[Cellulitis]]
* [[Coccidiomycosis]]
* [[Cold agglutinin disease]]
* Cold injury
* [[Congestive Heart Failure]]
* [[Contact dermatitis]]
* [[Decubitus ulcer]]
* [[Deep vein thrombosis]] ([[DVT]])
* [[Diabetes Mellitus]]
* [[Diabetic neuropathy]]
* [[Drugs]]
* Ecthyma
* [[Embolism]]
* [[Furuncle]]
* [[Gaucher's Disease]]
* [[Gout]]
* [[Histoplasmosis]]
* [[Insect bites]]
* [[Kaposi's Sarcoma]]
* [[Leprosy]]
* [[Leukemia]]
* [[Lymphangitis]]
* [[Lymphedema]]
* [[Macroglobulinemia]]
* [[Malnutrition]]
* [[Melanoma]]
* [[Metastase]]s
* [[Mycosis fungoides]]
* [[Osteomyelitis]]
* Other allergic conditions
* [[Peripheral vascular disease]]
* [[Polyarteritis]]
* [[Polycythemia Vera]]
* Protozoal infection
* [[Protein C deficiency]]
* [[Protein S deficiency]]
* [[Radiation]] [[dermatitis]]
* [[Raynaud's Syndrome]]
* [[Rheumatoid Arthritis]]
* [[Scleroderma]]
* [[Septic emboli]]
* [[Sickle Cell Anemia]]
* [[Sporotrichosis]]
* [[Squamous cell carcinoma]]
* [[Syringomyelia]]
* [[Systemic Lupus Erythematosus]]
* [[Tabes Dorsalis]]
* [[Thalassemia]]
* [[Trauma]]
* [[Tuberculosis]]
* [[Venous insufficiency]]


== References ==
== References ==
{{Reflist|2}}
{{Reflist|2}}


== Acknowledgements ==
[[Category:Crowdiagnosis]]
The content on this page was first contributed by
 
List of contributors:
 
----
== Suggested Reading and Key General References ==
 
== Suggested Links and Web Resources ==
 
== For Patients ==
 
 
 
[[Category:Dermatology]]
[[Category:Dermatology]]
[[Category:Signs and symptoms]]
[[Category:Up-To-Date]]


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Latest revision as of 18:12, 9 June 2015

Leg ulcer
Disseminated Intravascular Coagulation: Gross view of thighs and legs at autopsy ecchymoses with central necrosis and ulceration looks like pyoderma gangrenosum.
Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vendhan Ramanujam M.B.B.S [2]

Overview

Leg ulcers usually refer to ulcers of the lower leg. The most common cause of leg ulcers is venous insufficiency.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular Allergic vasculitis, anemia, aneurysm, angiosarcoma, arterial insufficiency, arterial thrombosis, arterio-venous malformation, arteriovenous fistula, arteriovenous malformation, atheroma, atherosclerosis, cholesterol embolism, venous insufficiency, Churg-Strauss syndrome, congestive heart failure, deep vein thrombosis, Degos disease, dehydration, diabetes mellitus, embolism, fibromuscular dysplasia, heart failure, hypertension, hypotension, hypothermia, kaposi's sarcoma, leukocytoclastic vasculitis, livedoid vasculopathy, lymphangitis, lymphatic obstruction, lymphatic vessel dysplasia, lymphedema, papulosis maligna atrophicans, peripheral artery disease, polyarteritis nodosa, polyarteritis, post-thrombotic syndrome, Raynaud's syndrome, sepsis, septic emboli, thromboangiitis obliterans, thrombotic thrombocytopenic purpura, varicose veins, vasculitis, venous valvular incompetence, Wegener's granulomatosis
Chemical/Poisoning Arsenic, spider bites
Dental No underlying causes
Dermatologic Acquired perforating dermatosis, actinic keratosis, advanced age, allergic vasculitis, amebiasis cutis, contact dermatitis, continuous trauma, Crohn's disease, cutaneous lymphoma ulcers, decubitus ulcer, ecthyma, erysipelas, erythema induratum of bazin, filariasis, furuncle, glanders, herpes simplex, keratoacanthoma, madura foot, melanoma, porphyria cutanea tarda, prolonged immobilization, radiodermatitis, sporotrichosis, squamous cell carcinoma, ulcerative colitis, xeroderma pigmentosum
Drug Side Effect Coumarin, ergotamine, cytostatic agents, halogens, hydroxyurea, leflunomide, methotrexate, penicillin, plasmin, plasminogen activator inhibitor-1, tissue plasminogen activator
Ear Nose Throat No underlying causes
Endocrine Diabetes mellitus, necrobiosis lipoidica
Environmental Burns, cold injury, contact dermatitis, heat, ionizing radiation, radiodermatitis
Gastroenterologic Crohn's disease, ulcerative colitis
Genetic Fibromuscular dysplasia, factor V Leiden mutation, Gaucher's disease, hereditary spherocytosis, Klinefelter syndrome, leukocyte adhesion deficiency, lymphatic vessel dysplasia, prolidase deficiency, tap1 mutation, thalassaemia, xeroderma pigmentosum
Hematologic Activated protein C resistance, anemia, antiphospholipid syndrome, antithrombin III deficiency, blood clot, cryoglobulinemia, deep vein thrombosis , dysproteinemia, essential thrombocythemia, factor V Leiden mutation, factor XIII deficiency, Felty's syndrome, granulocytopenia, hereditary spherocytosis, Langerhans cell histiocytosis, leukemia, leukocyte adhesion deficiency, lupus anticoagulant, macroglobulinemia, myelodysplasia, plasmin, plasminogen activator inhibitor-1, polyclonal dysproteinemia, polycythemia, polycythemia vera, primary polycythemia, primary thrombocythemia, protein C deficiency, protein S deficiency, purpura, sickle cell anemia, thalassemia, thrombotic thrombocytopenic purpura,tissue plasminogen activator
Iatrogenic Calcinosis cutis, cytostatic agents, radiodermatitis, vaccinations
Infectious Disease Actinomycosis, amoebiasis cutis, amoebiasis, anthrax, bacillary angiomatosis, bacterial infection, bacteroides, blastomycosis, borrelia vincenti, cellulitis, coccidiomycosis, cold agglutinin disease, diphtheria, ecthyma, ecthyma gangrenosum, ecthyma, erysipelas, fasciitis necroticans, filariasis, folliculitis, francisella tularensis, furuncle, gas gangrene, glanders, granuloma inguinale, haemophilus ducreyi, herpes simplex, histoplasmosis, kala-azar, leishmaniasis, leprosy, lues maligna, lymphangitis, madura foot, mycobacterium ulcerans, mycosis fungoides, osteomyelitis, papillomatosis cutis carcinoides, poliomyelitis, rodent ulcer, sepsis, septic emboli, sporotrichosis, syphilis, tinea pedis, tropical ulcer, tuberculosis, tularemia, variola virus, vasculitis, yaws
Musculoskeletal/Orthopedic Badly united fractures, bone fractures
Neurologic Alcoholic neuropathy, autonomic dysfunction, cerebral palsy, dementia, diabetic neuropathy, hemiplegia, multiple sclerosis, neuropathy, spina bifida, spinal cord injury, spinal cord lesions, syringomyelia
Nutritional/Metabolic Calcinosis cutis, calciphylaxis, gout, hyperhomocysteinemia, malnutrition, necrobiosis lipoidica, porphyria cutanea tarda,starvation
Obstetric/Gynecologic No underlying causes
Oncologic Angiosarcoma, basal cell carcinoma, cold agglutinin disease, cutaneous lymphoma ulcers, leukemia, macroglobulinemia, Marjolin's ulcer, melanoma, sarcoma, squamous cell carcinoma
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric Delirium, factitious ulceration
Pulmonary No underlying causes
Renal/Electrolyte Calciphylaxis
Rheumatology/Immunology/Allergy Rheumatoid arthritis
Sexual No underlying causes
Trauma Continuous trauma, bone fractures, lower limb nerve injury, Marjolin's ulcer, shearing forces, spinal cord injury
Urologic No underlying causes
Miscellaneous Amyloidosis, decubitus ulcer, friction, low weight, Marjolin's ulcer, prolonged immobilization, sarcoidosis

Causes in Alphabetical Order

References

  1. ↑ "Differential diagnosis of leg ulcers - Dissemond - 2006 - JDDG: Journal der Deutschen Dermatologischen Gesellschaft - Wiley Online Library". Retrieved 12 July 2013.
  2. ↑ "http://www.health.wa.gov.au/woundswest/docs/WPR_Nov09_Atypical_Leg_Ulcers.pdf" (PDF). Retrieved 12 July 2013. External link in |title= (help)

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