Ulcus cruris in differential dermatological diagnosis

Summary

The 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.

Zusammenfassung

Das Ulcus cruris ist in der Mehrheit venös und vaskulär bedingt. Daneben gibt es zahlreiche Erkrankungen, die ebenfalls ein Ulcus cruris hervorrufen können. Ist ein Ulcus cruris über Monate therapieresistent, sollten differenzialdiagnostische Überlegungen angestellt werden. Das Ziel dieser Arbeit ist auf die möglichen Ursachen für ein Ulcus cruris aufmerksam zu machen und im Einzelnen zu darzulegen.

Keywords

Leg ulcer - non-venous or vascular ulcers of the leg - differential diagnosis

Schlüsselwörter

Ulcus cruris - nicht venöse vaskuläre Beinulzera - Differenzialdiagnose

• Literatur

• 1 Altmeyer P. Enzyklopädie Dermatologie Ulcus cruris venosum. Heidelberg: Springer; 2008. 183.0
• 2 Dissemond J. Differenzialdiagnostische Aspekte des Ulcus cruris. Hartmann WundForum 2006; 2: 10-17.
• 3 Miller A, Ruzicka Th. Differentialdiagnose des Ulcus cruris. Hautarzt 2001; 52: 593-603.
• 4 Thiede R, Zabel M, Findeisen E. Ulcus cruris bei Necrobiosis lipoidica. Diagnostische und therapeutische Möglichkeiten. 43. Jahrestagung der Deutschen Gesellschaft für Phlebologie Bad Krozingen. 10.-13. Oktober 2001