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Aetiology

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Causes include:

  • vascular (1)
    • venous - ulceration following deep venous thrombosis, varicose veins
    • arterial - ischaemia, atherosclerosis, arteriovenous malformation
    • mixed
    • vasculitis - systemic lupus erythematosis, rheumatoid arthritis, scleroderma, polyarteritis nodosa, Wegener's granulomatosis
    • lymphatic
  • neuropathic - diabetes, tabes dorsalis, spina bifida, leprosy in endemic areas, peripheral neuropathy (1)
  • metabolic - diabetes, gout,
  • haematological - haemolytic anaemia, especially sickle cell disease, hereditary spherocytosis, polycythaemia rubra vera
  • malignancy - usually squamous cell skin carcinoma. Also Marjolin's ulcer or Bowen's disease
  • rheumatoid arthritis - ulceration is multifactorial
  • panniculitis - necrobiosis lipoidica - may be diabetic
  • gumma
  • pyoderma gangrenosum - often associated with ulcerative colitis
  • trauma e.g. traumatic flap lacerations over the shin; artefact, burns, cold injury, pressure sore, radiation, factitious (1)

Many leg ulcers have a multifactorial aetiology e.g. arterial ischaemia, venous hypertension, anaemia, infection (2).

Reference:

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