- It usually occurs in patients with blood pressure that is long standing and poorly controlled.
- Also associated with Diabetes Mellitus
- It affects women more than men.
- Commonly occur on the outer aspect of back of the lower leg just above the ankle. Over the Achilles tendon is another site of occurrence.
- Ulcers typically occur in the absence of significant arterial or venous disease.
- Strong, excruciating pain
- On Physical examination – solitary or symmetrical, affecting same site on both lower legs
- Red-purple inflamed ulcer edge
- Irregular shape
- Deep, exposing underlying tendons.
- Failure to respond to usual treatments for leg ulcers.
- Blood tests show elevated C-reactive protein and white blood cells.
- Better control of blood pressure
- Surgical debridement of the ulcer together with compression therapy, vacuum assisted closure.
- In case of large ulcers – skin grafting.
- Pain relief – Paracetamol and Non-steroidal anti-inflammatory drugs or opiates in case of severe pain.
- Antibiotics may be required for secondary bacterial infection.
- Stop smoking
- Compression stockings
- Protection from Trauma