Ulcer

Skin ulcer
Erythema nodosum – Skin ulcers that occur in some patients with inflammatory bowel disease
Medical specialty	Dermatology, surgery

Diabetic foot ulcer

An ulcer is a kind of open wound. Ulcers can be on surfaces of the body. They can be on skin. They can be mucous membranes like the surface of the stomach or inside the mouth.

Ulcers start when the top layer (surface) of skin or mucous membrane is damaged. The top layer dies. When it dies, the skin or mucous membrane opens. This leaves an open sore called an ulcer.

Ulcers can be from infection with germs. Ulcers can be from pressure on a part of the skin. Ulcers can be from substances that will burn skin or mucous membranes. Peptic ulcers are sometimes from burning by the acid in the stomach. Ulcers can be from cancer. Ulcers can be from diseases of blood vessels. If not enough blood goes to a body part, it can get an ulcer. Stress can also sometimes cause ulcers. Ulcers are often very painful.

Diagnosis

Grading

Wagner's grading of ulcer follows:

Grade	Description
0	Pre-ulcerative lesion or healed ulcer
1	Superficial ulcer
2	Ulcer deeper to subcutaneous tissue exposing soft tissue or bone
3	Abscess formation underneath, osteomyelitis
4	Gangrene of part of tissues, limb or foot
5	Gangrene of entire one area or foot

Specific types

• Arterial insufficiency ulcer: mostly located on the lateral surface of the ankle or the distal digits
• Cortisol ulcer: caused by long term application of cortisol (steroid) topical creams to certain skin diseases.
• Diabetic foot ulcer: a major complication of diabetes mellitus, and probably the major component of the diabetic foot.
• Venous ulcer: thought to occur due to improper functioning of venous valves, usually of the legs