Review article
DIFFERENTIAL DIAGNOSIS AND WORK UP OF CHRONIC LEG ULCERS
SANJA ŠPOLJAR
; Sestre milosrdnice University Hospital Center, University department of dermatovenereology, zagreb, Croatia
Abstract
Many factors contribute to the pathogenesis of leg ulcers. The main causes are chronic venous insufficiency, peripheral arterial occlusive disease (PAOD) and diabetes. Some leg ulcers are caused by combinations of these well-known etiologic factors. The most common cause of PAOD is arteriosclerosis. In diabetic patients, distal symmetric neuropathy and peripheral vascular disease are probably the most important etiologic factors in the development of leg ulcers. Less frequent causes of chronic leg ulcers are hematologic diseases, autoimmune diseases, genetic defects, infections, primary skin disease, cutaneous malignant diseases, use of some medications and therapeutic procedures, and numerous exogenous factors. Diagnosis of leg ulcer is made upon medical history, clinical picture, palpation of arteries, functional testing and serologic testing. Device-based diagnostic testing should be performed for additional clarification. Also, lesion biopsy should be taken for histopathology, direct immunofluorescence, bacteriology and mycology. The knowledge of differential diagnosis is essential for ensuring treatment success in a patient with leg ulcer.
Keywords
ulcer; differential diagnosis; chronic venous insufficiency; peripheral arterial occlusive disease; functional testing; serologic testing; biopsy; device-based diagnostic testing
Hrčak ID:
128707
URI
Publication date:
6.10.2014.
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