1. Ulcers
1.1. Persistent breach in the continuity of skin or mucous membrane associated with cell death.
1.2. Classifications
1.2.1. Benign
1.2.1.1. Specific
1.2.1.1.1. Tuberculosis
1.2.1.1.2. Syphilis
1.2.1.1.3. Actinomycosis
1.2.1.2. Non specific
1.2.1.2.1. Traumatic
1.2.1.2.2. Arterial
1.2.1.2.3. Venous
1.2.1.2.4. Trophic
1.2.1.2.5. Infection
1.2.1.2.6. Diabetic
1.2.2. Malignant
1.2.2.1. SCC
1.2.2.2. Rodent Ulcer (BCC).
1.2.2.3. Melanotic (MM)
1.3. Parts of ulcers
1.3.1. Margin
1.3.2. Edge
1.3.3. Floor
1.3.3.1. Granulation
1.3.3.2. Red • Pale & Smooth • Pink
1.3.3.3. Discharge • Serous • Purulent • Sero-purulent • Bloody • Sero-sanguinous
1.3.4. Base
1.3.4.1. On which the ulcer rests.
1.3.4.2. Palpated
1.3.4.3. Indurated in malignancy.
2. Diagnosis
2.1. History
2.1.1. Mode of onset.
2.1.2. Duration
2.1.3. Pain
2.1.4. Discharge
2.2. Examination
2.2.1. Inspection • Size & Shape • Number • Position • Edge, Margin, Floor • Discharge • Surrounding area
2.2.2. Palpation • Tenderness • Edge & margin • Base • Depth • Bleeding • Surrounding skin
2.2.3. Lymph Nodes.
2.2.4. Peripheral pulsations.
2.2.5. Sensory & motor examination.
2.2.6. Joints for mobility.
2.2.7. Systemic examination.
2.3. Investigation
2.3.1. Routine
2.3.2. Study of discharge
2.3.3. Edge biopsy
2.3.4. X-ray of the area
2.3.5. FNA of LN
2.3.6. Colour Doppler
2.4. Treatment
2.4.1. Treatment of the cause.
2.4.2. Correction of deficiencies.
2.4.3. Blood transfusions
2.4.4. Pain Management
2.4.5. Debridement, cleaning, dressing.
2.4.6. Antibiotics
2.4.7. Suturing, grafts, flaps.