Leg ulcer: Difference between revisions
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==Causes== | ==Causes== | ||
===Life Threatening Causes=== | ===Life Threatening Causes=== | ||
*[[Aneurysm]] | |||
*[[Arterial thrombosis]] | |||
*[[Arteriovenous fistula]] | |||
*[[Arterio-venous malformation]] | |||
*[[Blood clot]] | |||
*[[Burns]] | |||
*[[Cholesterol embolism]] | |||
*[[Immersion foot|Cold injury]] | |||
*[[Deep vein thrombosis]] | |||
*[[Dehydration]] | |||
*[[Delirium]] | |||
*[[Gas gangrene]] | |||
*[[Osteomyelitis]] | |||
===Common Causes=== | ===Common Causes=== | ||
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{|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 | |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]], [[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]], [[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]] | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Dermatologic''' | | '''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| | |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]], [[Impetigo | ecthyma]], [[erysipelas]], [[Bazin disease | erythema induratum of bazin]], [[filariasis]], [[furuncle]], [[glanders]], [[herpes simplex]], [[incontinence]], [[keratoacanthoma]], [[Eumycetoma | madura foot]], [[melanoma]], [[porphyria cutanea tarda]], [[Bedsore|prolonged immobilization]], [[radiodermatitis]], [[sporotrichosis]], [[squamous cell carcinoma]], [[ulcerative colitis]], [[xeroderma pigmentosum]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Genetic''' | | '''Genetic''' | ||
|bgcolor="Beige"| [[Fibromuscular dysplasia]], [[factor V Leiden mutation]], [[ | |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"| [[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]], [[ | |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" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Infectious Disease''' | | '''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 ]], [[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 | |bgcolor="Beige"| [[Actinomycosis]], [[Amoebiasis|amoebiasis cutis]], [[amoebiasis]], [[anthrax]], [[bacillary angiomatosis]], [[bacterial infection]], [[bacteroides]], [[blastomycosis]], [[Borrelia|borrelia vincenti]], [[cellulitis]], [[coccidiomycosis]], [[cold agglutinin disease]], [[diphtheria]], [[Impetigo | 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]] | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Oncologic''' | | '''Oncologic''' | ||
|bgcolor="Beige"| [[Angiosarcoma]], [[basal cell carcinoma]], [[cold agglutinin disease]], [[Lymphoma|cutaneous lymphoma ulcers]], [[leukemia]], [[macroglobulinemia]], [[ | |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" | ||
| '''Trauma''' | | '''Trauma''' | ||
|bgcolor="Beige"| [[Skin trauma|Continuous trauma]], [[bone fractures]], [[Sciatica|lower limb nerve 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 | |bgcolor="Beige"| [[Amyloidosis]], [[decubitus ulcer]], [[Factitious disorder|factitious ulceration]], [[friction]], [[Malnutrition|low weight]], [[Marjolin's ulcer]], [[Ulcer|moisture in the form of perspiration, feces, or urine]], [[The Heart in Köhlmeier-Degos Disease|papulosis maligna atrophicans]], [[Bedsore|prolonged immobilization]], [[sarcoidosis]], [[Spider bite|spider bites]] | ||
|- | |- | ||
|} | |} | ||
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*[[Antithrombin III deficiency]] | *[[Antithrombin III deficiency]] | ||
*[[Arsenic]] | *[[Arsenic]] | ||
*[[Arterial insufficiency]] | *[[Arterial insufficiency]] | ||
*[[Arterial thrombosis]] | *[[Arterial thrombosis]] | ||
*[[Arterio-venous malformation]] | *[[Arterio-venous malformation]] | ||
*[[Arteriovenous fistula]] | |||
*[[Arteriovenous | |||
*[[Atheroma]] | *[[Atheroma]] | ||
*[[Atherosclerosis]] | *[[Atherosclerosis]] | ||
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*[[Cerebral palsy]] | *[[Cerebral palsy]] | ||
*[[Cholesterol embolism]] | *[[Cholesterol embolism]] | ||
*[[Churg-Strauss syndrome]] | *[[Churg-Strauss syndrome]] | ||
*[[Coccidiomycosis]] | *[[Coccidiomycosis]] | ||
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*[[Lymphoma|Cutaneous lymphoma ulcers]] | *[[Lymphoma|Cutaneous lymphoma ulcers]] | ||
*[[Decubitus ulcer]] | *[[Decubitus ulcer]] | ||
*[[Deep vein thrombosis ]] | *[[Deep vein thrombosis]] | ||
*[[Dehydration]] | *[[Dehydration]] | ||
*[[Delirium]] | *[[Delirium]] | ||
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*[[Erysipelas]] | *[[Erysipelas]] | ||
*[[Bazin disease | Erythema induratum of bazin]] | *[[Bazin disease | Erythema induratum of bazin]] | ||
*[[Essential thrombocythemia]] | |||
{{col-break|width=33%}} | {{col-break|width=33%}} | ||
* | *[[Chemotherapy | 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]] | ||
*[[Fibromuscular dysplasia]] | |||
*[[Filariasis]] | *[[Filariasis]] | ||
*[[Folliculitis]] | *[[Folliculitis]] | ||
*[[ | *[[Francisella tularensis]] | ||
*[[Friction]] | *[[Friction]] | ||
*[[Furuncle]] | *[[Furuncle]] | ||
*[[Gas gangrene ]] | *[[Gas gangrene]] | ||
*[[Gaucher's disease]] | *[[Gaucher's disease]] | ||
*[[Glanders]] | *[[Glanders]] | ||
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*[[Keratoacanthoma]] | *[[Keratoacanthoma]] | ||
*[[Klinefelter syndrome]] | *[[Klinefelter syndrome]] | ||
*[[Lack of exercise]] | *[[Obesity|Lack of exercise]] | ||
*[[Langerhans cell histiocytosis]] | *[[Langerhans cell histiocytosis]] | ||
*[[Leflunomide]] | *[[Leflunomide]] | ||
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*[[Leukocytoclastic vasculitis]] | *[[Leukocytoclastic vasculitis]] | ||
*[[Livedoid vasculopathy]] | *[[Livedoid vasculopathy]] | ||
*[[Low weight]] | *[[Malnutrition|Low weight]] | ||
*[[Sciatica|Lower limb nerve injury]] | *[[Sciatica|Lower limb nerve injury]] | ||
*[[Syphilis | Lues maligna]] | *[[Syphilis | Lues maligna]] | ||
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*[[Melanoma]] | *[[Melanoma]] | ||
*[[Methotrexate]] | *[[Methotrexate]] | ||
*[[Moisture in the form of perspiration, feces, or urine]] | *[[Ulcer|Moisture in the form of perspiration, feces, or urine]] | ||
*[[Multiple sclerosis]] | *[[Multiple sclerosis]] | ||
*[[Mycobacterium ulcerans]] | *[[Mycobacterium ulcerans]] | ||
*[[Mycosis fungoides]] | *[[Mycosis fungoides]] | ||
*[[Myelodysplasia]] | *[[Myelodysplasia]] | ||
*[[Necrobiosis lipoidica]] | *[[Necrobiosis lipoidica]] | ||
*[[Neuropathy]] | *[[Neuropathy]] | ||
{{col-break|width=33%}} | |||
*[[Osteomyelitis]] | *[[Osteomyelitis]] | ||
*[[Human papillomavirus|Papillomatosis cutis carcinoides]] | *[[Human papillomavirus|Papillomatosis cutis carcinoides]] | ||
*[[Papulosis maligna atrophicans]] | *[[The Heart in Köhlmeier-Degos Disease|Papulosis maligna atrophicans]] | ||
*[[Pemphigus vulgaris]] | *[[Pemphigus vulgaris]] | ||
*[[Penicillin]] | *[[Penicillin]] | ||
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*[[Polycythemia vera]] | *[[Polycythemia vera]] | ||
*[[Porphyria cutanea tarda]] | *[[Porphyria cutanea tarda]] | ||
*[[Post thrombotic syndrome]] | *[[Post-thrombotic syndrome]] | ||
*[[Polycythemia vera | Primary polycythemia]] | *[[Polycythemia vera | Primary polycythemia]] | ||
*[[Primary thrombocythemia]] | *[[Primary thrombocythemia]] | ||
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*[[Sjogren syndrome]] | *[[Sjogren syndrome]] | ||
*[[Smoking]] | *[[Smoking]] | ||
*[[Spider bites]] | *[[Spider bite|Spider bites]] | ||
*[[Spina bifida]] | *[[Spina bifida]] | ||
*[[Spinal cord injury]] | *[[Spinal cord injury]] | ||
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*[[Tuberculosis]] | *[[Tuberculosis]] | ||
*[[Tularemia]] | *[[Tularemia]] | ||
*[[Ulcerative pyoderma]] | *[[Impetigo|Ulcerative pyoderma]] | ||
*[[Ulcerative colitis]] | *[[Ulcerative colitis]] | ||
*[[Vaccinations]] | *[[Vaccinations]] | ||
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{{col-end}} | {{col-end}} | ||
== Differential Diagnosis of Leg Ulcer== | ==Differential Diagnosis of Leg Ulcer== | ||
* [[Anemia]] | * [[Anemia]] | ||
* [[Arteriosclerosis]] | * [[Arteriosclerosis]] | ||
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* [[Blister | Bullous Disease]] | * [[Blister | Bullous Disease]] | ||
* [[Buerger's disease]] | * [[Buerger's disease]] | ||
* [[ | * [[Burns]] | ||
* [[Cellulitis]] | * [[Cellulitis]] | ||
* [[Coccidiomycosis]] | * [[Coccidiomycosis]] | ||
* [[Cold agglutinin disease]] | * [[Cold agglutinin disease]] | ||
* [[Cold injury]] | * [[Immersion foot|Cold injury]] | ||
* [[Congestive heart failure]] | * [[Congestive heart failure]] | ||
* [[Contact dermatitis]] | * [[Contact dermatitis]] | ||
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* [[Diabetic neuropathy]] | * [[Diabetic neuropathy]] | ||
* [[Drugs]] | * [[Drugs]] | ||
* [[Ecthyma]] | * [[Impetigo | Ecthyma]] | ||
* [[Embolism]] | * [[Embolism]] | ||
* [[Furuncle]] | * [[Furuncle]] | ||
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* [[Mycosis fungoides]] | * [[Mycosis fungoides]] | ||
* [[Osteomyelitis]] | * [[Osteomyelitis]] | ||
* [[Other allergic conditions]] | * [[Allergy history and symptoms|Other allergic conditions]] | ||
* [[Peripheral vascular disease]] | * [[Peripheral vascular disease]] | ||
* [[Polyarteritis]] | * [[Polyarteritis]] |
Revision as of 19:26, 22 July 2013
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]; 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
- Aneurysm
- Arterial thrombosis
- Arteriovenous fistula
- Arterio-venous malformation
- Blood clot
- Burns
- Cholesterol embolism
- Cold injury
- Deep vein thrombosis
- Dehydration
- Delirium
- Gas gangrene
- Osteomyelitis
Common Causes
- Basal Cell Carcinoma
- Decubitus ulcer
- Deep vein thrombosis
- Diabetes mellitus
- Hypertension
- Peripheral artery disease
- Rheumatoid ulcers
- Squamous cell carcinoma
- Thromboangiitis obliterans
- Venous insufficiency
- Vasculitis[1][2]
Causes by Organ System
Causes in Alphabetical Order
Differential Diagnosis of Leg Ulcer
- Anemia
- Arteriosclerosis
- Arteriovenous malformation
- Basal cell carcinoma
- Blastomycosis
- Bullous Disease
- Buerger's disease
- Burns
- 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[3][4]
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) - ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
- ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X