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| Ulcer | ||
| Etiology •A number of conditions can result in ulcers of the skin. •Acute ulcers may result from a variety of causes, including infections, neoplasms, chemical or thermal injury. •Chronic ulcers result from neoplasms, vascular injury, debilitation, and neurological conditions where the patient is unaware of injury to the affected part. | ||
| Pathogenesis •An ulcer is an area of loss of the epithelium, with acute or chronic inflammation in the underlying connective tissue. •Ulcers may be acute or chronic, depending upon the nature of the inflammatory process. •In acute ulcer, the epithelium is lost and there is edema, congestion, and polymorphonuclear leukocyte infiltration in the underlying tissue. •In a chronic ulcer, there may be exuberant proliferation of young capillaries with plump fibroblasts and chronic inflammatory cells including lymphocytes and macrophages (granulation tissue)., | ||
| Epidemiology •Common | ||
| General Gross Description •Grossly, there is a breach in the epidermis with acute or chronic granulation tissue below. •Examples: | ||
| General Microscopic Description •Acute ulcers show evidence of acute inflammation. •Chronic ulcers have chronic granulation tissue at the base. •Examples: | ||
| Clinical Correlation •Depending upon the cause, acute ulcers are self-limiting with appropriate treatment. •Chronic ulcers, especially if large, need replacement of the ulcer bed and skin grafting to provide fresh epithelium to grow over the affected area. | ||
| References • Harrison's Principles of Internal Medicine, 13th Edition: Isselbach et. al. (eds). New York, McGraw-Hill, 1994, pp. 562 Please be patient during transfer. Medline will open in a new window. To return, close the Medline Window Ulcer
| Synopsis by: T.V.Rajan, M.D., Ph.D. (T01000M38120)[524]
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