Leg ulcer: Difference between revisions

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	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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Latest revision as of 18:12, 9 June 2015

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

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

Template:WH Template:WS

[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)

[1]

[2]

@@ Line 5: / Line 5: @@
    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>|}}
 {{SI}}
-{{CMG}}; {{VR}}
+{{CMG}}; {{AE}} {{VR}}
 ==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==
+===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===
 *[[Basal Cell Carcinoma]]
-*Chronic [[venous insufficiency]]
 *[[Decubitus ulcer]]
 *[[Deep vein thrombosis]]
@@ Line 22: / Line 34: @@
 *[[Squamous cell carcinoma]]
 *[[Thromboangiitis obliterans]]
+*[[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>
@@ Line 27: / Line 40: @@
 {|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 [[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]],  [[post thrombotic syndrome]],  [[raynaud's syndrome]],  [[sepsis ]],  [[septic emboli]],  [[thromboangiitis obliterans]],  [[thrombotic thrombocytopenic purpura]],  [[varicose veins]],  [[vasculitis]],  venous [[dysplasia]],  [[venous valvular incompetence]],  [[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"
 | '''Chemical/Poisoning'''
-|bgcolor="Beige"| [[Arsenic]]
+|bgcolor="Beige"| [[Arsenic]], [[Spider bite|spider bites]]
 |-
 |-bgcolor="LightSteelBlue"
@@ Line 39: / Line 52: @@
 |-bgcolor="LightSteelBlue"
 | '''Dermatologic'''
-|bgcolor="Beige"| [[Actinic keratosis]],  [[advanced age]],  [[allergic vasculitis]],  [[amoebiasis]] cutis,  [[contact dermatitis]],  [[continuous trauma]],  [[Crohn's disease]],  [[decubitus ulcer]],  [[Impetigo | ecthyma]],  [[erysipelas]],  [[Bazin disease | erythema induratum of bazin]],  [[filariasis]],  [[furuncle]],  [[glanders]],  [[herpes simplex]],  [[incontinence]],  [[keratoacanthoma]],  [[lymphoma]] ulcers,  [[Eumycetoma | madura foot]],  [[melanoma]],  [[acquired 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"
 | '''Drug Side Effect'''
-|bgcolor="Beige"| [[Coumarin]],  [[ergotamine]],  extravasated [[Chemotherapy | cytostatic agents]],  [[halogens]],  [[hydroxyurea]],  [[leflunomide]],  [[methotrexate]],  [[penicillin]],  [[plasmin]],  [[plasminogen activator inhibitor-1]],  [[tissue plasminogen activator]]
+|bgcolor="Beige"| [[Coumarin]], [[ergotamine]], [[Chemotherapy | cytostatic agents]], [[halogens]], [[hydroxyurea]], [[leflunomide]], [[methotrexate]], [[penicillin]], [[plasmin]], [[plasminogen activator inhibitor-1]], [[tissue plasminogen activator]]
 |-
 |-bgcolor="LightSteelBlue"
@@ Line 51: / Line 64: @@
 |-bgcolor="LightSteelBlue"
 | '''Endocrine'''
-|bgcolor="Beige"| [[Diabetes mellitus]],  [[necrobiosis lipoidica]]
+|bgcolor="Beige"| [[Diabetes mellitus]], [[necrobiosis lipoidica]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Environmental'''
-|bgcolor="Beige"| [[Burns]],  [[cold injury]],  [[contact dermatitis]],  [[heat]],  [[ionizing radiation]],  radiation [[dermatitis]]
+|bgcolor="Beige"| [[Burns]], [[Immersion foot|cold injury]], [[contact dermatitis]], [[heat]], [[ionizing radiation]], [[radiodermatitis]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Gastroenterologic'''
-|bgcolor="Beige"| [[Crohn's disease]],  [[incontinence]],  [[ulcerative colitis]]
+|bgcolor="Beige"| [[Crohn's disease]], [[ulcerative colitis]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Genetic'''
-|bgcolor="Beige"| Arterial [[dysplasia]],  [[factor V Leiden mutation]],  [[gaucher's disease]],  [[hereditary spherocytosis]],  [[klinefelter syndrome]],  [[leukocyte adhesion deficiency]],  lymphatic vessel [[dysplasia]],  [[prolidase deficiency]], [[tap1 mutation]],  [[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"
 | '''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]],  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="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]],  extravasated [[Chemotherapy | cytostatic agents]],  radiation [[dermatitis]],  [[vaccinations]]
+|bgcolor="Beige"| [[Calcinosis cutis]], [[Chemotherapy | cytostatic agents]], [[radiodermatitis]],  [[vaccinations]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''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 ]],  [[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]],  [[papillomatosis cutis carcinoides]],  [[poliomyelitis]],  [[rodent ulcer]],  [[sepsis ]],  [[septic emboli]],  [[sporotrichosis]],  [[syphilis]],  [[tinea pedis]],  [[tropical ulcer]],  [[tuberculosis]],  [[tularemia]],  [[ulcerative 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"
 | '''Musculoskeletal/Orthopedic'''
-|bgcolor="Beige"| Badly united [[fractures]],  lower limb [[fractures]]
+|bgcolor="Beige"| [[bone fractures|Badly united fractures]], [[bone fractures]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Neurologic'''
-|bgcolor="Beige"| [[Alcoholic neuropathy]],  [[autonomic dysfunction]],  [[dementia]],  [[diabetic neuropathy]],  [[hemiplegia]],  infantile [[cerebral 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"
 | '''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"
@@ Line 95: / Line 108: @@
 |-bgcolor="LightSteelBlue"
 | '''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"
@@ Line 107: / Line 120: @@
 |-bgcolor="LightSteelBlue"
 | '''Psychiatric'''
-|bgcolor="Beige"| [[Delirium]]
+|bgcolor="Beige"| [[Delirium]], [[Factitious disorder|factitious ulceration]]
 |-
 |-bgcolor="LightSteelBlue"
@@ Line 115: / Line 128: @@
 |-bgcolor="LightSteelBlue"
 | '''Renal/Electrolyte'''
-|bgcolor="Beige"| [[Calciphylaxis]],  [[incontinence]]
+|bgcolor="Beige"| [[Calciphylaxis]]
 |-
 |-bgcolor="LightSteelBlue"
@@ Line 127: / Line 140: @@
 |-bgcolor="LightSteelBlue"
 | '''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"
@@ Line 135: / Line 148: @@
 |-bgcolor="LightSteelBlue"
 | '''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]]
 |-
 |}
@@ Line 149: / Line 162: @@
 *[[Alcoholic neuropathy]]
 *[[Allergic vasculitis]]
-*[[Amoebiasis]] cutis
+*[[Amoebiasis|Amoebiasis cutis]]
 *[[Amoebiasis]]
 *[[Amyloidosis]]
@@ Line 159: / Line 172: @@
 *[[Antithrombin III deficiency]]
 *[[Arsenic]]
-*[[Artefacts]]
-*Arterial [[dysplasia]]
 *[[Arterial insufficiency]]
 *[[Arterial thrombosis]]
 *[[Arterio-venous malformation]]
-*Arteriovenous [[fistulas]]
+*[[Arteriovenous fistula]]
-*[[Arteriovenous malformation]]
 *[[Atheroma]]
 *[[Atherosclerosis]]
@@ Line 172: / Line 182: @@
 *[[Bacterial infection]]
 *[[Bacteroides]]
-*Badly united [[fracture]]
+*[[bone fractures|Badly united fracture]]
 *[[Basal cell carcinoma]]
 *[[Behcet disease ]]
 *[[Blastomycosis]]
 *[[Blood clot]]
-*[[Borrelia vincenti]]
+*[[Bone fractures]]
+*[[Borrelia|Borrelia vincenti]]
 *[[Bullous pemphigoid]]
 *[[Burns]]
@@ Line 183: / Line 194: @@
 *[[Calciphylaxis]]
 *[[Cellulitis]]
+*[[Cerebral palsy]]
 *[[Cholesterol embolism]]
-*Chronic [[venous insufficiency]]
-*[[Chronically injured or diseased skin]]
 *[[Churg-Strauss syndrome]]
 *[[Coccidiomycosis]]
 *[[Cold agglutinin disease]]
-*[[Cold injury]]
+*[[Immersion foot|Cold injury]]
 *[[Congestive heart failure]]
 *[[Contact dermatitis]]
-*Continuous [[trauma]]
+*[[Skin trauma|Continuous trauma]]
 *[[Coumarin]]
 *[[Crohn's disease]]
 *[[Cryoglobulinemia]]
-*Cutaneous [[lymphoma]]
+*[[Lymphoma|Cutaneous lymphoma ulcers]]
 *[[Decubitus ulcer]]
-*[[Deep vein thrombosis ]]
+*[[Deep vein thrombosis]]
+* [[Degos disease]]
 *[[Dehydration]]
 *[[Delirium]]
@@ Line 207: / Line 218: @@
 *[[Dysproteinemia]]
 *[[Ecthyma gangrenosum]]
-*[[Impetigo | Ecthyma]]
+*[[Ecthyma gangrenosum | Ecthyma]]
 *[[Embolism]]
 *[[Ergotamine]]
@@ Line 214: / Line 225: @@
 {{col-break|width=33%}}
 *[[Essential thrombocythemia]]
-*Extravasated [[Chemotherapy | cytostatic agents]]
+*[[Chemotherapy | Extravasated cytostatic agents]]
-*[[Factitious ulceration]]
+*[[Factitious disorder|Factitious ulceration]]
 *[[Factor V Leiden mutation]]
 *[[Factor XIII deficiency]]
 *[[Fasciitis necroticans ]]
 *[[Felty's syndrome]]
+*[[Fibromuscular dysplasia]]
 *[[Filariasis]]
 *[[Folliculitis]]
-*[[Franciscella tularensis]]
+*[[Francisella tularensis]]
 *[[Friction]]
 *[[Furuncle]]
-*[[Gas gangrene ]]
+*[[Gas gangrene]]
 *[[Gaucher's disease]]
 *[[Glanders]]
@@ Line 244: / Line 256: @@
 *[[Hypotension]]
 *[[Hypothermia]]
-*[[Incontinence]]
-*Infantile [[cerebral palsy]]
 *[[Ionizing radiation]]
 *[[Kala-azar]]
@@ Line 251: / Line 261: @@
 *[[Keratoacanthoma]]
 *[[Klinefelter syndrome]]
-*[[Lack of exercise]]
+*[[Obesity|Lack of exercise]]
 *[[Langerhans cell histiocytosis]]
 *[[Leflunomide]]
@@ Line 260: / Line 270: @@
 *[[Leukocytoclastic vasculitis]]
 *[[Livedoid vasculopathy]]
-*[[Low weight]]
+*[[Underweight|Low weight]]
-*Lower limb [[fractures]]
+*[[Sciatica|Lower limb nerve injury]]
-*[[Lower limb nerve injury]]
 *[[Syphilis | Lues maligna]]
 *[[Lupus anticoagulant]]
@@ Line 268: / Line 277: @@
 *[[Lymphangitis]]
 *[[Lymphatic obstruction]]
-*Lymphatic vessel [[dysplasia]]
+*[[Lymphedema|Lymphatic vessel dysplasia]]
 *[[Lymphedema]]
-*[[Lymphoma]] ulcers
 *[[Macroglobulinemia]]
 *[[Eumycetoma | Madura foot]]
@@ Line 276: / Line 284: @@
 *[[Marjolin's ulcer]]
 *[[Melanoma]]
-*[[Metastatic tumours]]
 *[[Methotrexate]]
-*[[Moisture in the form of perspiration, feces, or urine]]
 *[[Multiple sclerosis]]
 *[[Mycobacterium ulcerans]]
 *[[Mycosis fungoides]]
 *[[Myelodysplasia]]
-{{col-break|width=33%}}
 *[[Necrobiosis lipoidica]]
 *[[Neuropathy]]
 *[[Osteomyelitis]]
-*[[Papillomatosis cutis carcinoides]]
+{{col-break|width=33%}}
-*[[Papulosis maligna atrophicans]]
+*[[Human papillomavirus|Papillomatosis cutis carcinoides]]
+*[[Degos disease|Papulosis maligna atrophicans]]
 *[[Pemphigus vulgaris]]
 *[[Penicillin]]
@@ Line 298: / Line 304: @@
 *[[Polyarteritis nodosa]]
 *[[Polyarteritis]]
-*Polyclonal [[dysproteinemia]]
+*[[Dysproteinemia|Polyclonal dysproteinemia]]
 *[[Polycythemia vera]]
 *[[Porphyria cutanea tarda]]
-*[[Post thrombotic syndrome]]
+*[[Post-thrombotic syndrome]]
-*[[Polycythemia vera | Primary polycythemia]]
+*[[Polycythemia vera |Primary polycythemia]]
 *[[Primary thrombocythemia]]
 *[[Prolidase deficiency]]
-*[[Prolonged Immobilization]]
+*[[Bedsore|Prolonged immobilization]]
 *[[Protein C deficiency]]
 *[[Protein S deficiency]]
 *[[Purpura]]
 *[[Pyoderma gangrenosum]]
-*Radiation [[dermatitis]]
+*[[Radiodermatitis]]
 *[[Raynaud's syndrome]]
 *[[Rheumatoid arthritis]]
@@ Line 319: / Line 325: @@
 *[[Sepsis ]]
 *[[Septic emboli]]
-*[[Shearing forces]]
+*[[Physical trauma|Shearing forces]]
 *[[Sickle cell anemia]]
 *[[Sjogren syndrome]]
 *[[Smoking]]
-*[[Spider bites]]
+*[[Spider bite|Spider bites]]
 *[[Spina bifida]]
 *[[Spinal cord injury]]
@@ Line 333: / Line 339: @@
 *[[Syringomyelia]]
 *[[Systemic lupus erythematosus]]
-*[[Tap1 mutation]]
+*[[Leprosy|Tap1 mutation]]
 *[[Thalassemia]]
 *[[Thromboangiitis obliterans]]
@@ Line 339: / Line 345: @@
 *[[Tinea pedis]]
 *[[Tissue plasminogen activator]]
-*[[Tropical ulcer]]
+*[[Cutaneous leishmaniasis|Tropical ulcer]]
 *[[Tuberculosis]]
 *[[Tularemia]]
-*[[Ulcerative pyoderma]]
+*[[Impetigo|Ulcerative pyoderma]]
 *[[Ulcerative colitis]]
 *[[Vaccinations]]
@@ Line 348: / Line 354: @@
 *[[Variola virus]]
 *[[Vasculitis]]
-*Venous [[dysplasia]]
+*[[Venous insufficiency]]
-*[[Venous valvular incompetence]]
+*[[Chronic Venous insufficiency|Venous valvular incompetence]]
 *[[Wegener's granulomatosis]]
 *[[Xeroderma pigmentosum]]
 *[[Yaws]]
 {{col-end}}
-== Differential diagnosis of leg ulcer==
-* [[Anemia]]
-* [[Arteriosclerosis]]
-* [[Arteriovenous malformation]]
-* [[Basal cell carcinoma]]
-* [[Blastomycosis]]
-* [[Blister | Bullous Disease]]
-* [[Buerger's disease]]
-* [[Burn]]s
-* [[Cellulitis]]
-* [[Coccidiomycosis]]
-* [[Cold agglutinin disease]]
-* [[Cold injury]]
-* [[Congestive heart failure]]
-* [[Contact dermatitis]]
-* [[Decubitus ulcer]]
-* [[Deep vein thrombosis]]
-* [[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]]
-* [[Metastasis]]
-* [[Mycosis fungoides]]
-* [[Osteomyelitis]]
-* [[Other allergic conditions]]
-* [[Peripheral vascular disease]]
-* [[Polyarteritis]]
-* [[Polycythemia vera]]
-* [[Protozoan 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]]<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>
 == References ==
 {{Reflist|2}}
+[[Category:Crowdiagnosis]]
 [[Category:Dermatology]]
-[[Category:Signs and symptoms]]
+[[Category:Up-To-Date]]
 {{WH}}
 {{WS}}


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