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{{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}}
{{CMG}}; {{AE}} {{VR}}
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{{Editor Help}}


==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]].


== Differential diagnosis of causes of a leg ulcer==  
==Causes==
===Life Threatening Causes===
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.


In alphabetical order. <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>
*[[Aneurysm]]
*[[Arterial thrombosis]]
*[[Blood clot]]
*[[Burns]]
*[[Cholesterol embolism]]
*[[Immersion foot|Cold injury]]
*[[Deep vein thrombosis]]
*[[Gas gangrene]]
*[[Osteomyelitis]]


* [[Anemia]]
===Common Causes===
* [[Arteriosclerosis]]
*[[Basal Cell Carcinoma]]
* [[Arteriovenous malformation]]
*[[Decubitus ulcer]]
* [[Basal cell carcinoma]]
*[[Deep vein thrombosis]]
* [[Blastomycosis]]
*[[Diabetes mellitus]]
* Bullous Disease
*[[Hypertension]]
* [[Buerger's disease]]
*[[Peripheral artery disease]]
* [[Burn]]s
*[[Rheumatoid arthritis|Rheumatoid ulcers]]
* [[Cellulitis]]
*[[Squamous cell carcinoma]]
* [[Coccidiomycosis]]
*[[Thromboangiitis obliterans]]
* [[Cold agglutinin disease]]
*[[Venous insufficiency]]
* Cold injury
*[[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>
* [[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 ==
===Causes by Organ System===
{{Reflist}}
{|style="width:82%; height:100px" border="1"
|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 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"
| '''Chemical/Poisoning'''
|bgcolor="Beige"| [[Arsenic]], [[Spider bite|spider bites]]
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|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"
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Coumarin]], [[ergotamine]], [[Chemotherapy | cytostatic agents]], [[halogens]], [[hydroxyurea]], [[leflunomide]], [[methotrexate]], [[penicillin]], [[plasmin]], [[plasminogen activator inhibitor-1]], [[tissue plasminogen activator]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| [[Diabetes mellitus]], [[necrobiosis lipoidica]]
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| [[Burns]], [[Immersion foot|cold injury]], [[contact dermatitis]], [[heat]], [[ionizing radiation]], [[radiodermatitis]]
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| [[Crohn's disease]], [[ulcerative colitis]]
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|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"
| '''Hematologic'''
|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"
| '''Iatrogenic'''
|bgcolor="Beige"| [[Calcinosis cutis]], [[Chemotherapy | cytostatic agents]], [[radiodermatitis]],  [[vaccinations]]
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|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"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| [[bone fractures|Badly united fractures]], [[bone fractures]]
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|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"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| [[Calcinosis cutis]], [[calciphylaxis]], [[gout]], [[hyperhomocysteinemia]], [[malnutrition]], [[necrobiosis lipoidica]], [[porphyria cutanea tarda]],[[starvation]]
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|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"
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| [[Delirium]], [[Factitious disorder|factitious ulceration]]
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| [[Calciphylaxis]]
|-
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| [[Rheumatoid arthritis]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|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"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| [[Amyloidosis]], [[decubitus ulcer]], [[friction]], [[underweight|low weight]], [[Marjolin's ulcer]], [[Bedsore|prolonged immobilization]], [[sarcoidosis]]
|-
|}


== Acknowledgements ==
===Causes in Alphabetical Order===
The content on this page was first contributed by
{{col-begin|width=85%}}
{{col-break|width=33%}}
*[[Acquired perforating dermatosis]]
*[[Actinic keratosis]]
*[[Actinomycosis]]
*[[Activated protein C resistance]]
*[[Advanced age]]
*[[Alcoholic neuropathy]]
*[[Allergic vasculitis]]
*[[Amoebiasis|Amoebiasis cutis]]
*[[Amoebiasis]]
*[[Amyloidosis]]
*[[Anemia]]
*[[Aneurysm]]
*[[Angiosarcoma]]
*[[Anthrax]]
*[[Antiphospholipid syndrome]]
*[[Antithrombin III deficiency]]
*[[Arsenic]]
*[[Arterial insufficiency]]
*[[Arterial thrombosis]]
*[[Arterio-venous malformation]]
*[[Arteriovenous fistula]]
*[[Atheroma]]
*[[Atherosclerosis]]
*[[Autonomic dysfunction]]
*[[Bacillary angiomatosis]]
*[[Bacterial infection]]
*[[Bacteroides]]
*[[bone fractures|Badly united fracture]]
*[[Basal cell carcinoma]]
*[[Behcet disease ]]
*[[Blastomycosis]]
*[[Blood clot]]
*[[Bone fractures]]
*[[Borrelia|Borrelia vincenti]]
*[[Bullous pemphigoid]]
*[[Burns]]
*[[Calcinosis cutis]]
*[[Calciphylaxis]]
*[[Cellulitis]]
*[[Cerebral palsy]]
*[[Cholesterol embolism]]
*[[Churg-Strauss syndrome]]
*[[Coccidiomycosis]]
*[[Cold agglutinin disease]]
*[[Immersion foot|Cold injury]]
*[[Congestive heart failure]]
*[[Contact dermatitis]]
*[[Skin trauma|Continuous trauma]]
*[[Coumarin]]
*[[Crohn's disease]]
*[[Cryoglobulinemia]]
*[[Lymphoma|Cutaneous lymphoma ulcers]]
*[[Decubitus ulcer]]
*[[Deep vein thrombosis]]
* [[Degos disease]]
*[[Dehydration]]
*[[Delirium]]
*[[Dementia]]
*[[Diabetes mellitus]]
*[[Diabetic neuropathy]]
*[[Diphtheria]]
*[[Dysproteinemia]]
*[[Ecthyma gangrenosum]]
*[[Ecthyma gangrenosum | Ecthyma]]
*[[Embolism]]
*[[Ergotamine]]
*[[Erysipelas]]
*[[Bazin disease | Erythema induratum of bazin]]
{{col-break|width=33%}}
*[[Essential thrombocythemia]]
*[[Chemotherapy | Extravasated cytostatic agents]]
*[[Factitious disorder|Factitious ulceration]]
*[[Factor V Leiden mutation]]
*[[Factor XIII deficiency]]
*[[Fasciitis necroticans ]]
*[[Felty's syndrome]]
*[[Fibromuscular dysplasia]]
*[[Filariasis]]
*[[Folliculitis]]
*[[Francisella tularensis]]
*[[Friction]]
*[[Furuncle]]
*[[Gas gangrene]]
*[[Gaucher's disease]]
*[[Glanders]]
*[[Gout]]
*[[Granulocytopenia]]
*[[Granuloma inguinale]]
*[[Halogens]]
*[[Heart failure]]
*[[Heat]]
*[[Hemiplegia]]
*[[Haemophilus ducreyi]]
*[[Hereditary spherocytosis]]
*[[Herpes simplex]]
*[[Histoplasmosis]]
*[[Hydroxyurea]]
*[[Hyperhomocysteinemia]]
*[[Hypertension]]
*[[Hypotension]]
*[[Hypothermia]]
*[[Ionizing radiation]]
*[[Kala-azar]]
*[[Kaposi's sarcoma]]
*[[Keratoacanthoma]]
*[[Klinefelter syndrome]]
*[[Obesity|Lack of exercise]]
*[[Langerhans cell histiocytosis]]
*[[Leflunomide]]
*[[Leishmaniasis]]
*[[Leprosy]]
*[[Leukemia]]
*[[Leukocyte adhesion deficiency]]
*[[Leukocytoclastic vasculitis]]
*[[Livedoid vasculopathy]]
*[[Underweight|Low weight]]
*[[Sciatica|Lower limb nerve injury]]
*[[Syphilis | Lues maligna]]
*[[Lupus anticoagulant]]
*[[Lupus erythematosus]]
*[[Lymphangitis]]
*[[Lymphatic obstruction]]
*[[Lymphedema|Lymphatic vessel dysplasia]]
*[[Lymphedema]]
*[[Macroglobulinemia]]
*[[Eumycetoma | Madura foot]]
*[[Malnutrition]]
*[[Marjolin's ulcer]]
*[[Melanoma]]
*[[Methotrexate]]
*[[Multiple sclerosis]]
*[[Mycobacterium ulcerans]]
*[[Mycosis fungoides]]
*[[Myelodysplasia]]
*[[Necrobiosis lipoidica]]
*[[Neuropathy]]
*[[Osteomyelitis]]
{{col-break|width=33%}}
*[[Human papillomavirus|Papillomatosis cutis carcinoides]]
*[[Degos disease|Papulosis maligna atrophicans]]
*[[Pemphigus vulgaris]]
*[[Penicillin]]
*[[Peripheral artery disease]]
*[[Phlebitis]]
*[[Plasmin]]
*[[Plasminogen activator inhibitor-1]]
*[[Poliomyelitis]]
*[[Polyarteritis nodosa]]
*[[Polyarteritis]]
*[[Dysproteinemia|Polyclonal dysproteinemia]]
*[[Polycythemia vera]]
*[[Porphyria cutanea tarda]]
*[[Post-thrombotic syndrome]]
*[[Polycythemia vera |Primary polycythemia]]
*[[Primary thrombocythemia]]
*[[Prolidase deficiency]]
*[[Bedsore|Prolonged immobilization]]
*[[Protein C deficiency]]
*[[Protein S deficiency]]
*[[Purpura]]
*[[Pyoderma gangrenosum]]
*[[Radiodermatitis]]
*[[Raynaud's syndrome]]
*[[Rheumatoid arthritis]]
*[[Rodent ulcer]]
*[[Sarcoidosis]]
*[[Sarcoma]]
*[[Scleroderma]]
*[[Sepsis ]]
*[[Septic emboli]]
*[[Physical trauma|Shearing forces]]
*[[Sickle cell anemia]]
*[[Sjogren syndrome]]
*[[Smoking]]
*[[Spider bite|Spider bites]]
*[[Spina bifida]]
*[[Spinal cord injury]]
*[[Spinal cord lesions]]
*[[Sporotrichosis]]
*[[Squamous cell carcinoma]]
*[[Starvation]]
*[[Syphilis]]
*[[Syringomyelia]]
*[[Systemic lupus erythematosus]]
*[[Leprosy|Tap1 mutation]]
*[[Thalassemia]]
*[[Thromboangiitis obliterans]]
*[[Thrombotic thrombocytopenic purpura]]
*[[Tinea pedis]]
*[[Tissue plasminogen activator]]
*[[Cutaneous leishmaniasis|Tropical ulcer]]
*[[Tuberculosis]]
*[[Tularemia]]
*[[Impetigo|Ulcerative pyoderma]]
*[[Ulcerative colitis]]
*[[Vaccinations]]
*[[Varicose veins]]
*[[Variola virus]]
*[[Vasculitis]]
*[[Venous insufficiency]]
*[[Chronic Venous insufficiency|Venous valvular incompetence]]
*[[Wegener's granulomatosis]]
*[[Xeroderma pigmentosum]]
*[[Yaws]]
{{col-end}}


List of contributors:
== References ==
 
{{Reflist|2}}
----
== Suggested Reading and Key General References ==
 
== Suggested Links and Web Resources ==
 
== For Patients ==
 
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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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