Inflammatory Ulcers

Abstract

A large number of diseases can eventuate in cutaneous ulceration. This article will review inflammatory disorders which by their nature can directly produce cutaneous breakdown and ulcer formation. Major emphasis is given to those disorders where recent knowledge has improved our understanding of the condition or where new therapeutic agents or maneuvers have become available. This later group consists of vasculitis, disorders caused by small vessel thrombi or embolus and pyoderma gangrenosusm.

Contents

“…Abnormal skin color is an important observation. Red skin may indicate a cellulitis pressure area, vasculitis, arterial disease, suboptimal patient or wound care, or contact dermatitis 2,43 , 44 . Macerated skin indicates large amounts of exudate or moisture at the wound base and prolonged exposure time of the skin to moisture.…”

“…Red skin may indicate a cellulitis pressure area, vasculitis, arterial disease, suboptimal patient or wound care, or contact dermatitis. 2,43,44 Macerated skin indicates large amounts of exudate or moisture at the wound base and prolonged exposure time of the skin to moisture. A purplish skin tone may signal an underlying hematoma or an area of ischemia, or it may be related to cryoglobulinemia or vasculitis.…”

Vasculitic Ulcers

“…The histological feature of the leukocytoclastic vasculitis (LV), in which the neutrophil granulocytes are predominant, is the hallmark of a large part of CV, as results from lesional biopsy. 6 The fibrinoid necrosis of the vessel wall is the histological sign that allows one to make a diagnosis of vasculitis. Other less frequent histological aspects are the granulomatous vasculitis (polymorphic infiltrate with presence of histiocytes, lymphocytes, and neutrophils; Figure 7) and the lymphocytic vasculitis in which the lymphomonocytes are predominant.…”

Microangiopathic Ulcers of the Lower Extremities: A Daily Challenge

“…A well-known group of primitively microangiopathic diseases accounts for 4% to 6% of lower limb ulcers. 2 It includes several disorders that compromise microvessels and specifically the cutaneous vascular system: arterioles, capillaries, and postcapillary venules. They may associate or complicate other ulcer-predisposing disturbances (ie, chronic venous insufficiency, neuroischemic disorders) and provide explanations for nonhealing ulcers or delayed tissue repair.…”

“…A special mention must be made of pyoderma gangrenosum (PG), which is a neutrophil-mediated inflammatory ulcer that is frequently associated with internal diseases. 2 Specific clinical findings, such as violaceous submined ulcerative borders, are the markers of the disease. They may not be present continuously but may be seen during active phases of PG.…”