Leg ulcer

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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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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

Common Causes

Causes by Organ System

Cardiovascular 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
Chemical/Poisoning Arsenic
Dental No underlying causes
Dermatologic 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, acquired perforating dermatosis, porphyria cutanea tarda, prolonged immobilization, radiation dermatitis, sporotrichosis, squamous cell carcinoma, ulcerative colitis, xeroderma pigmentosum
Drug Side Effect Coumarin, ergotamine, extravasated 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, radiation dermatitis
Gastroenterologic Crohn's disease, incontinence, ulcerative colitis
Genetic 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
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, extravasated cytostatic agents, radiation dermatitis, vaccinations
Infectious Disease 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, 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, ulcerative pyoderma, variola virus, vasculitis, yaws
Musculoskeletal/Orthopedic Badly united fractures, lower limb fractures
Neurologic Alcoholic neuropathy, autonomic dysfunction, dementia, diabetic neuropathy, hemiplegia, infantile cerebral palsy, 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, leukemia, lymphoma ulcers, macroglobulinemia, marjolin's ulcer, melanoma, metastatic tumours, sarcoma, squamous cell carcinoma
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric Delirium
Pulmonary No underlying causes
Renal/Electrolyte Calciphylaxis, incontinence
Rheumatology/Immunology/Allergy Rheumatoid arthritis
Sexual No underlying causes
Trauma Continuous trauma, lower limb fractures, lower limb nerve injury, marjolin's ulcer, shearing forces, spinal cord injury
Urologic No underlying causes
Miscellaneous 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

Causes in Alphabetical Order

Differential diagnosis of leg ulcer

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)
  3. ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  4. ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

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