A lesion on an epithelial surface (skin or mucous membrane) caused by superficial loss of tissue.   is a persistent discontinuity; Breach of skin of an epithelial surface that can occur in the skin or mucosa of the elementary and respiratory tracts.

Pressure ulcers; Bedridden patients

Exam Ulcer

- Causes:

1- recurrent physical injury  
2- recurrent chemical injury  
3- Ischemia  
4- neoplastic changes  
5- poor healing (malnutrition / systemic disease)

- Differential Diagnosis

- Venous ulcer 
- Arterial ulcer 
- Traumatic (Neuropathic, 
- Infective 
- Neoplastic

History similar to the lump

  • Duration of the current symptoms (when & How noticed); usually chronic
  • What drew the patient attention? (discharges, bad smell, bleeding, …)
  • Course of the ulcer since appearance (size, shape, discharge, if healed and broken down now)
  • Associated Sx?(fever, sensation changes) 
  • Any other ulcers elsewhere?
  • Hx of previous Trauma / burn / bare foot 
  • Any Tx had been suggested or administered? 
  • DM controlled? confirms differential diagnosis