Arms and Legs Ulcer

Ulcers on the arms and legs.

Ulcers due to stasis,arterial insufficiency,neuropathy and diabetes tend to occur in acral areas on the lower legs and arms.Skin malignancies in these areas may break down into ulcers.Several rarer diseases cause ulcers on the legs eg Necrobiosis lipoidica,Ecthyma,Antiphospholipid syndrome particularly around the ankle and pretibial areas,Prolidase deficiency,and pyoderma gangrenosum.A biopsy is therefore obligatory in any chronic ulcer in these areas.Vasculitic syndromes such as polyateritis nodosa and calciphyaxis will also cause ulcers secondary to vessel damage.Never forget factitial ulcers.

Eschar   Ecthyma gangrenosum,Anthrax,Lymphomatoid papulosis,Mucha-Habermann disease (PLEVA)

SIGN DIP MEN  Overview of Ulcers

 

S-Squamous

 

I-Infective   Mycobacterium ulcerans, TB, syphilis, Yaws, Leishmaniasis, Anthrax, Noma, Coccidioidomycosis and Herpes Zoster

 

G-Granulomatous  Midline lethal granuloma and Wegener’s granulomatosis

 

N-Neoplastic   Squamous cell and basal cell skin cancer, Secondary malignancy

 

D-Drugs

 

I-Immunological  Pyoderma gangrenosum

 

P-Physical   Traumatic,Venous ,Arterial,Neuropathic, Trauma, Heat, Cold, Facticial, Trigeminotrophic syndrome

 

M-Metabolic   Porphyria cutanea tarda,

 

E-Endocrine

 

N-Nutritional

 

Others   Temporal arteritis,