Other causes ulcers Flashcards
(15 cards)
Who typically develops tropical ulcers?
Children and adults residing in the rural tropics, often malnourished or debilitated
May also occur in travelers returning from these areas.
What are the characteristics of tropical ulcers?
Phagedenic, usually leg, often occurs after minor trauma, painful with undermined and violaceous edges
Typically associated with polymicrobial infection.
Which bacteria are commonly associated with tropical ulcers?
Fusobacterium spp., other anaerobic bacteria, spirochetes
This polymicrobial infection is a key feature.
What diagnostic methods are used for tropical ulcers?
Smears, cultures, MRI for deep involvement assessment
These methods help determine the extent of the infection.
What treatments are recommended for tropical ulcers?
Antibiotics (e.g. tetracycline, metronidazole), non-adherent dressings, surgical debridement if necessary
Treatment aims to manage infection and promote healing.
What are some differential diagnoses for tropical ulcers?
Bacterial, mycobacterial, deep fungal, parasitic infections (e.g. leishmaniasis), sickle cell disease, venous ulcers, trauma, PAD
Important to distinguish from other ulcerative conditions.
What is diffuse dermal angiomatosis?
An unusual manifestation of vascular atherosclerosis characterized by violaceous plaques in a reticulated pattern
Often accompanied by central ulceration.
What is the typical location of diffuse dermal angiomatosis plaques?
Lower extremities, but can occur elsewhere (e.g. breast, forearm)
These painful plaques can develop rapidly.
What histological finding is associated with diffuse dermal angiomatosis?
Diffuse proliferation of CD31+ve endothelial cells within papillary and reticular dermis
This histological feature aids in diagnosis.
How is diffuse dermal angiomatosis resolved?
Correction of underlying PAD (e.g. femoral popliteal bypass) leads to rapid resolution
Addressing the underlying issue is crucial for treatment.
What is a major cause of delayed healing time in patients?
Anaemia
Often underrecognized as a contributing factor.
What types of haematological malignancies are associated with ulcerative processes?
PG, vasculitis, cryoglobulinaemia (especially Type 1)
These conditions can lead to the development of ulcers.
What tests are included in a thrombophilia screen?
CBC, blood film, Chem20, ESR, aPTT/PT/INR/fibrinogen, ANCA, Factor V Leiden, Protein C/S activity, Prothrombin mutation G20210A, Antithrombin III activity, APC resistance, lupus anticoagulant, B2 glycoprotein antibody, anticardiolipin antibody, cryoglobulins, cryofibrinogens, cold agglutinins, hyperhomocysteinaemia
Comprehensive testing is essential to identify clotting abnormalities.
List the causes of leg ulceration from common to least common
what are drug causes of ucleration + sites?
- Hydroxyurea - lower extremities
- MTX - pso plaques
- Warfarin - fatty areas eg breasts
- Heparin - injection sites, and distant sites
- all-trans retinoin acid (systemic) - scrotum
- interferon - injuction site
- NSAID, penicillin, hydroxyzine, vitamin K, bismuth salts, chlorpheniramine - sites of IM injection
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