Exam

Skin Ulcer

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Skin Ulcer, Skin Erosion, Skin Ulceration, Skin and Subcutaneous Tissue Ulceration

  • Definitions
  1. Skin Erosion
    1. Focal, superficial epidermal loss
    2. Heals without scarring
  2. Skin Ulceration
    1. Focal loss of Epidermis and Dermis
    2. Ulcers heal with scar formation
  • Differential Diagnosis
  • Erosion
  1. Dermatophyte infection or Candidiasis
  2. Eczematous Dermatitis
  3. Herpes Simplex Virus
  4. Intertrigo
  5. Excoriations (include Neurotic Excoriations)
  6. Aging Skin
  7. Toxic Epidermal Necrolysis
  8. Vesicles and Bullae
  • Differential Diagnosis
  • Ulceration
  1. See Oral Ulcer
  2. See Genital Ulcer
  3. External skin injury
    1. Skin Trauma
    2. Skin picking
    3. Envenomation (e.g. Brown Recluse Spider Bite)
    4. Decubitus Ulcer
  4. Bacterial Skin Infection
    1. Streptococcus (e.g. Ecthyma)
    2. Staphylococcus (e.g. Impetigo)
    3. Pseudomonas
    4. Treponema pallidum (Syphilis)
    5. Mycobacterium ulcerans (Buruli Ulcer)
    6. Haemophilus ducreyi (Chancroid)
  5. Viral Skin Infections
    1. Herpes Simplex Virus
    2. Coxsachievirus
  6. Fungal Skin Infections
    1. Coccidiomycosis
    2. Mucormycosis
  7. Parasitic Skin Infections
    1. Leishmaniasis
    2. Amoebiasis
    3. Schistosomiasis
  8. Medium or Small Vessel Vasculitis
    1. Polyarteritis Nodosa
    2. Microangiopathic Vasculitis
    3. Granulomatosis with Polyangiitis (previously known as Wegener's Granulomatosis)
    4. Rheumatoid Arthritis
    5. Necrobiosis Lipoidica (associated with Diabetes Mellitus)
  9. Vascular insufficiency
    1. Arterial Insufficiency
    2. Venous Stasis Ulcer
    3. Antiphospholipid Antibody Syndrome
  10. Skin Inflammation (Neutrophilic dematoses)
    1. Pyoderma Gangrenosum
  11. Skin Neoplasm
    1. Non-Melanoma skin cancer (basal cell skin cancer, Squamous Cell Skin Cancer)
  • References
  1. Jhun and DeClerck in Herbert (2015) EM:Rap 15(8): 19-20