Characteristics of leg ulcers 1. Venous ulceration: Often large, shallow ulcers with an irregular, ill- defined border on the lower leg & ankle. Associated with hemosedrin deposition, edema, varicosities, atrophie blanche. Lipodermatosclerosis, stasis dermatitis & subcutaneous calcification. 2. Post- coagulant ulcers: similar to venous ulcers but smaller. Occur in hematological disorders such as sickle cell disease, hereditery spherocytosis & anterior tibial syndrome. 3. Arterial ulcers: Round, sharply demarcated ulcers in distal sites && over bony prominences. Associated with hailess, shiny atrophic skin, claudication, poor peripheral pulses, reduced capillary refil, cold feet & thickened toenails.

Leg ulcers (Continue) 4. Neuropathic (trophic) ulcers: Distal ulceration overlying pressure sites associated with reduced sensation. Occurs in a number of neurological disorders including diabetes, leprosy, tabes dorsalis, porphyries, amyloid, nerve injury& spinal pathology 5. Pressur ulcers: Ulcer overlying bony prominences in immobile patientscommonly on the sacrum,hips & mallolii. 6. Vasculitic ulcers: Occur over dependant areas & are often painful, associated with cutaneous vasculitic rashes.. 7. Pyoderma gangrenosum: The ulcerative variant has an undermined border& surrounding erythema. It typically begins on the legs or trunk but can occur at any site. Diagnosis is often of exclusion as laboratory & histopathology findings are varient & non specific. Frequent disease association include:

Leg ulcers ( inflammatory bowel Most inflammatory arthritis, vasculitic & connective tissue Hematological paraproteinemias & Sweet’s syndrome & other neutrophilic dermatosis 8. Infective ulcers: Rare, a number of causes including brucellosis, leprosy, leishmaniasis & typical mycobacterium.