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Ulcer
Definition : A break in the continuity of the covering epithelium of the skin or mucous membrane.
Causes due to molecular death or traumatic removal
PARTS OF ULCER
Now what are the parts or ulcer ;
there are four parts : Base , floor , edge and margin
Base is the surface on which the ulcer rest .
Floor is the exposed surface of ulcer .
The junction between normal epithelium and ulcer is known as margin .
The edge is the area between margin and floor .
The base is formed by muscle or bone .
Types of edge :
.Sloping edge : seen in healing ulcer .
.Punched out edge : seen in arterial ulcer or ishchemic ulcer .
.Undermined edge : is a typical feature of tubercular ulcer
.Rolled edge : it is seen in basal cell carcinoma , pearly white edges are also seen .
.Everted edges : seen in squamous cell carcinoma , indurated base is the characteristic feature of squamous cell carcinoma
CLASSIFICATION OF ULCER
Is based on three factors :
. etiological classification
.clinical classification
. Pathological classification
Etiological classification:
Traumatic ulcer , vascular ulcer, neoplastic ulcer , metabolic ulcers , ulcers due to malnutrition.
Clinical classification:
Spreading ulcer , healing ulcer , callous ulcer
In spreading ulcer :the surrounding skin is inflamed .
Floor is covered by slough .
No evidence of granulation tissue
Purulent discharge .
In healing ulcer : sorrounding skin is not inflamed
Floor is covered with granulation tissue , edges show bluish outline and slight serous discharge
In callous ulcer : we can see pale granulation tissue on the floor and considerable induration at the base , edge and surrounding skin . It shows no tendency towards healing .
Pathological classification:
Non specific ulcers
Specific ulcers
Malignant ulcers
Nonspecific: traumatic ulcers
Arterial ulcers due to ischemia like gangrene.
Venous ulcer example : vericose ulcer .
Neurogenic ulcer or trophic ulcer
Ulcer associated with malnutrition.
Specific ulcers : syphilis ulcers , tuberculous ulcer ,fungal ulcers .
Malignant ulcers : these includes : basal cell carcinoma , squamous cell carcinoma , malignant melanoma
TREATMENTS
Conservative treatment:
.Dressing
.treat infections like bacterial , fungal , TB etc .
.topical microbial agents can be given
. Nutritional support
. Control blood glucose
. Compression bandage
Surgical treatment :
. Sloughectomy
. Skin grafting .
COMPLICATIONS OF ULCER
.chronic osteomyelitis
.malignant change
. Septicaemia
This is all about ulcer thank you !
