The diagnosis and medical management of vascular ulcers

Abstract

Of the many causes of non-traumatic, chronic skin ulceration in the lower extremities, vascular diseases are, by far, the most common etiologic factors. Consequently, there is a tendency to label patients as having peripheral vascular disease whenever recurrent leg ulcers are found, sometimes leading to inappropriate therapy. One cannot ascribe an etiologic diagnosis to a leg ulcer by its appearance alone, but must take into account the clinical context in which it occurs. The purposes of this chapter are to review the clinical features associated with various kinds of vascular ulcers and to discuss diagnostic methods and the appropriate medical therapy. Vascular ulcers are broadly divided into those associated with arterial insufficiency and those related to venous disorders.