*Skin ulcers

Question 1

Basic causes of ulcers, Mcc of ulcers on leg and foot

Answer 1

Arterial, venous and mixed, autoimmune
mc ulcer leg - venous
mc ulcer foot - arterial

Question 2

Arterial vs venous ulcer

Answer 2

Venous ulcer:
1. Above and around ankle
2. Wet, oedematous, ooze+
3. Pain - mild
4. Ulcer - ragged edge, superficial
5. Warm leg
6. Varicosities, pigmentation (haemosiderin deposite)
7. ABI >0.9 (normal)

Arterial ulcer:
1. Below ankle
2. Dry. ooze -
3. Pain - severe
4. Ulcer - punched out, deep
5. Cold leg
6. Absent pulse, Thin, shiny skin
7. ABI <0.5-0.7

Question 3

Initial inv in peripheral vascular disease (PVD)

Answer 3

ABI - Ankle brachial index
Using doppler USG
N: 0.91 - 1.3
Sev PVD: <0.5
Moderate PVD/Claudicant: 0.5-0.9

Question 4

Mx of arterial ulcer

Answer 4

Looks tidy comparatively
At pressure points

Rx the cause

Question 5

*Venous ulcer mx

Answer 5

*Main rx - compression stockings,
leg elevation
Ambulation exercises, Bed rest
Wet dressing - ulcers

Question 6

Trophic ulcer

Answer 6

In diabetic neuropathy
Deep seated
NO PAIN
Control DM, antibiotics
Might need sx referral