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    Ulcers: DR Sarah Mutwakil Abbas Diab MBBS, Mrcsed, Mhpe

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    Sarah M. A. Diab
    Ulcers can have various causes and are classified in different ways. Examination of an ulcer involves inspecting features like size, edges, and discharge, as well as palpating the edge, base, and surrounding area to evaluate characteristics like induration, tenderness, and mobility which can indicate if the ulcer is infected, arterial, or potentially malignant like squamous cell carcinoma. Investigations may include blood tests, imaging, and biopsy to determine the underlying cause and guide treatment, which aims to address the cause, manage pain and infection, and promote healing.

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    Ulcers: DR Sarah Mutwakil Abbas Diab MBBS, Mrcsed, Mhpe

    Uploaded by

    Sarah M. A. Diab
    36 views33 pages
    Ulcers can have various causes and are classified in different ways. Examination of an ulcer involves inspecting features like size, edges, and discharge, as well as palpating the edge, base, and surrounding area to evaluate characteristics like induration, tenderness, and mobility which can indicate if the ulcer is infected, arterial, or potentially malignant like squamous cell carcinoma. Investigations may include blood tests, imaging, and biopsy to determine the underlying cause and guide treatment, which aims to address the cause, manage pain and infection, and promote healing.

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    Ulcers for medical students

    Original Title

    Ulcers

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    Ulcers can have various causes and are classified in different ways. Examination of an ulcer involves inspecting features like size, edges, and discharge, as well as palpating the edge, base, and surrounding area to evaluate characteristics like induration, tenderness, and mobility which can indicate if the ulcer is infected, arterial, or potentially malignant like squamous cell carcinoma. Investigations may include blood tests, imaging, and biopsy to determine the underlying cause and guide treatment, which aims to address the cause, manage pain and infection, and promote healing.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    36 views33 pages

    Ulcers: DR Sarah Mutwakil Abbas Diab MBBS, Mrcsed, Mhpe

    Uploaded by

    Sarah M. A. Diab
    Ulcers can have various causes and are classified in different ways. Examination of an ulcer involves inspecting features like size, edges, and discharge, as well as palpating the edge, base, and surrounding area to evaluate characteristics like induration, tenderness, and mobility which can indicate if the ulcer is infected, arterial, or potentially malignant like squamous cell carcinoma. Investigations may include blood tests, imaging, and biopsy to determine the underlying cause and guide treatment, which aims to address the cause, manage pain and infection, and promote healing.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 33

    Ulcers

    Dr Sarah Mutwakil Abbas Diab


    MBBS, MRCSEd, MHPE
    Content
    • Definition
    • Aetiology
    • Classification
    • Examination
    • Investigations
    Definition
    • “A break down of epithelial integrity”
    • Death
    • Traumatic removal
    Aetiology
    • Venous disease
    • Arterial disease
    • Trauma
    • Infection
    • Neoplasia
    Classification

    Classification

    Clinical Pathological
    Clinical
    • Spreading
    • Healing
    • Callous
    Pathological
    • Specific
    • Non specific
    • Malignant
    Specific
    • Tuberculosis
    • Syphilis
    • Actinomycosis
    • Meleney’s ulcer
    Non specific
    • Traumatic Ulcer
    • Arterial Ulcer
    • Venous Ulcer
    • Neuropathic Ulcer
    • Infective Ulcer
    • Diabetic Ulcer
    Arterial ulcer
    Venous ulcer
    Neuropathic ulcer
    Malignant
    • Squamous cell ca
    • Basal cell ca
    • Malignant melanoma
    Squamous cell carcinoma
    Basal cell carcinoma
    Examination

    Neurovascular
    Inspection Palpation Lymph nodes state of the
    limb
    Inspection
    • Site
    • Size
    • Shape
    • Floor
    • Edge
    • Discharge
    • Surrounding area
    Site
    Floor
    Describing the ulcer edges
    Discharge
    Surrounding area
    Palpation
    • Edge
    • Base
    • Mobility
    • Bleeding
    • Surrounding
    Edge
    • Induration (hardness) of the edge is very
    • characteristic of squamous cell carcinoma.
    • It is said to be a host defense mechanism.
    • Tenderness of the edge is characteristic of infected ulcers and arterial
    ulcers.
    Base
    • It is the area on which ulcer rests.
    • Marked induration at the base is diagnostic of squamous cell
    carcinoma.
    What does induration indicate?
    Mobility
    • Gentle attempt is made to move the
    • ulcer to know its fixity to the underlying
    • tissues.
    • Malignant ulcers are usually fixed, benign
    • ulcers are not.
    Bleeding
    • Malignant ulcer is friable like a cauliflower.
    • On gentle palpation, it bleeds.
    • Granulation tissue as in a healing ulcer
    • also causes bleeding.
    Surrounding area
    • Thickening and induration is found in squamous cell carcinoma.
    • Tenderness and pitting on pressure indicates spreading inflammation
    surrounding the ulcer.
    Regional lymph nodes
    Investigations
    • Full blood count
    • Urine analysis
    • Blood sugar
    • Chest X-ray - PA. view to rule out P.TB
    • Pus for culture/sensitivity
    • Lower limb angiography in cases of arterial diseases
    • X-ray of the part to see for Osteomyelitis
    • Biopsy: Non-healing/malignant ulcers
    Treatment
    • Address cause
    • Correct deficiencies
    • Control pain, infection
    • Debridement, dressing
    • Closure of defect

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