Ulcus cruris in differential dermatological diagnosis

Abstract

SummaryThe leg ulcer is mostly caused by vascular or venous diseases. About 1% of the German population suffer from a leg ulcer. 50–80% of the leg ulcers are caused by chronic venous insufficiency. Besides, there are many other diseases which can develop a leg ulcer. If a leg ulcer does not heal over months of therapy there are many other differential diagnosis possible. The ulcer is only a symptom, not a diagnosis.Following diseases can induce leg ulcer: vasculitis, rheumatoid arthritis, cryoglobulinaemia, livedo vasculitis, polyarthritis nodosa, haematological, neuropathic, infectious and metabolic disorders, necrobiosis lipoidica (diabeticorum), pyoderma gangraenosum, calciphylaxis, arterial hypertension, chemical and physical injuries. The different diseases are discussed. For the diagnosis it is important that a detailed anamnesis, a typical statement, laboratory and histological findings exist. Sometimes the cooperation between several medical disciplines is necessary. Only an exact diagnosis can induce a differentiated therapy and in many cases the leg ulcer heal up. The aim of this paper is a survey of various non venous or vascular reasons for the development of leg ulcer. However the survey is not completed. But the main causes are mentioned.