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The exact cause of lipodermatosclerosis is unknown. [3] [6] Venous disease, such as venous incompetence, venous hypertension, and body mass may be relevant to the underlying pathogenesis. [3] Increased blood pressure in the veins (venous hypertension) can cause diffusion of substances, including fibrin, out of capillaries.
[1] Venous ulcers are wounds that are thought to occur due to improper functioning of venous valves, usually of the legs (hence leg ulcers). [2]: 846 They are an important cause of chronic wounds, affecting 1% of the population. [3] Venous ulcers develop mostly along the medial distal leg, and can be painful with negative effects on quality of ...
[12] [11] Ulcers do occur in the absence of pathological infection. Diagnosis of an infected wound is classically made with ≥2 signs of inflammation or purulence. [13] Peripheral pulses should also be evaluated (posterior tibial and dorsal pedis), and if not palpable, should be further evaluated using ultrasound. [12]
Other causes producing skin ulcers include bacterial and viral infections, fungal infections [6] and cancers. Blood disorders and chronic wounds can result in skin ulcers as well. [7] Venous leg ulcers due to impaired circulation or a blood flow disorder are more common in the elderly.
The management of arterial insufficiency ulcers depends on the severity of the underlying arterial insufficiency. The affected region can sometimes be revascularized via vascular bypass or angioplasty. If infection is present, appropriate antibiotics are prescribed. When proper blood flow is established, debridement is performed. If the wound ...
Diabetics have a 15% higher risk for amputation than the general population [2] due to chronic ulcers. Diabetes causes neuropathy, which inhibits nociception and the perception of pain. [2] Thus patients may not initially notice small wounds to legs and feet, and may therefore fail to prevent infection or repeated injury. [8]
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The first sign of infection is a small painless nodule or area of swelling, typically on the arms or legs. The nodule grows larger over days to weeks, eventually forming an open ulcer. Deep ulcers can cause scarring of muscles and tendons, resulting in permanent disability.