Leg ulcer

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Leg ulcer
Leg ulcer 001.jpg
Disseminated Intravascular Coagulation: Gross view of thighs and legs at autopsy ecchymoses with central necrosis and ulceration looks like pyoderma gangrenosum.
Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vendhan Ramanujam M.B.B.S [2]


Leg ulcers usually refer to ulcers of the lower leg. The most common cause of leg ulcers is venous insufficiency.


Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular Allergic vasculitis, anemia, aneurysm, angiosarcoma, arterial insufficiency, arterial thrombosis, arterio-venous malformation, arteriovenous fistula, arteriovenous malformation, atheroma, atherosclerosis, cholesterol embolism, venous insufficiency, Churg-Strauss syndrome, congestive heart failure, deep vein thrombosis, Degos disease, dehydration, diabetes mellitus, embolism, fibromuscular dysplasia, heart failure, hypertension, hypotension, hypothermia, kaposi's sarcoma, leukocytoclastic vasculitis, livedoid vasculopathy, lymphangitis, lymphatic obstruction, lymphatic vessel dysplasia, lymphedema, papulosis maligna atrophicans, peripheral artery disease, polyarteritis nodosa, polyarteritis, post-thrombotic syndrome, Raynaud's syndrome, sepsis, septic emboli, thromboangiitis obliterans, thrombotic thrombocytopenic purpura, varicose veins, vasculitis, venous valvular incompetence, Wegener's granulomatosis
Chemical/Poisoning Arsenic, spider bites
Dental No underlying causes
Dermatologic Acquired perforating dermatosis, actinic keratosis, advanced age, allergic vasculitis, amebiasis cutis, contact dermatitis, continuous trauma, Crohn's disease, cutaneous lymphoma ulcers, decubitus ulcer, ecthyma, erysipelas, erythema induratum of bazin, filariasis, furuncle, glanders, herpes simplex, keratoacanthoma, madura foot, melanoma, porphyria cutanea tarda, prolonged immobilization, radiodermatitis, sporotrichosis, squamous cell carcinoma, ulcerative colitis, xeroderma pigmentosum
Drug Side Effect Coumarin, ergotamine, cytostatic agents, halogens, hydroxyurea, leflunomide, methotrexate, penicillin, plasmin, plasminogen activator inhibitor-1, tissue plasminogen activator
Ear Nose Throat No underlying causes
Endocrine Diabetes mellitus, necrobiosis lipoidica
Environmental Burns, cold injury, contact dermatitis, heat, ionizing radiation, radiodermatitis
Gastroenterologic Crohn's disease, ulcerative colitis
Genetic Fibromuscular dysplasia, factor V Leiden mutation, Gaucher's disease, hereditary spherocytosis, Klinefelter syndrome, leukocyte adhesion deficiency, lymphatic vessel dysplasia, prolidase deficiency, tap1 mutation, thalassaemia, xeroderma pigmentosum
Hematologic Activated protein C resistance, anemia, antiphospholipid syndrome, antithrombin III deficiency, blood clot, cryoglobulinemia, deep vein thrombosis , dysproteinemia, essential thrombocythemia, factor V Leiden mutation, factor XIII deficiency, Felty's syndrome, granulocytopenia, hereditary spherocytosis, Langerhans cell histiocytosis, leukemia, leukocyte adhesion deficiency, lupus anticoagulant, macroglobulinemia, myelodysplasia, plasmin, plasminogen activator inhibitor-1, polyclonal dysproteinemia, polycythemia, polycythemia vera, primary polycythemia, primary thrombocythemia, protein C deficiency, protein S deficiency, purpura, sickle cell anemia, thalassemia, thrombotic thrombocytopenic purpura,tissue plasminogen activator
Iatrogenic Calcinosis cutis, cytostatic agents, radiodermatitis, vaccinations
Infectious Disease Actinomycosis, amoebiasis cutis, amoebiasis, anthrax, bacillary angiomatosis, bacterial infection, bacteroides, blastomycosis, borrelia vincenti, cellulitis, coccidiomycosis, cold agglutinin disease, diphtheria, ecthyma, ecthyma gangrenosum, ecthyma, erysipelas, fasciitis necroticans, filariasis, folliculitis, francisella tularensis, furuncle, gas gangrene, glanders, granuloma inguinale, haemophilus ducreyi, herpes simplex, histoplasmosis, kala-azar, leishmaniasis, leprosy, lues maligna, lymphangitis, madura foot, mycobacterium ulcerans, mycosis fungoides, osteomyelitis, papillomatosis cutis carcinoides, poliomyelitis, rodent ulcer, sepsis, septic emboli, sporotrichosis, syphilis, tinea pedis, tropical ulcer, tuberculosis, tularemia, variola virus, vasculitis, yaws
Musculoskeletal/Orthopedic Badly united fractures, bone fractures
Neurologic Alcoholic neuropathy, autonomic dysfunction, cerebral palsy, dementia, diabetic neuropathy, hemiplegia, multiple sclerosis, neuropathy, spina bifida, spinal cord injury, spinal cord lesions, syringomyelia
Nutritional/Metabolic Calcinosis cutis, calciphylaxis, gout, hyperhomocysteinemia, malnutrition, necrobiosis lipoidica, porphyria cutanea tarda,starvation
Obstetric/Gynecologic No underlying causes
Oncologic Angiosarcoma, basal cell carcinoma, cold agglutinin disease, cutaneous lymphoma ulcers, leukemia, macroglobulinemia, Marjolin's ulcer, melanoma, sarcoma, squamous cell carcinoma
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric Delirium, factitious ulceration
Pulmonary No underlying causes
Renal/Electrolyte Calciphylaxis
Rheumatology/Immunology/Allergy Rheumatoid arthritis
Sexual No underlying causes
Trauma Continuous trauma, bone fractures, lower limb nerve injury, Marjolin's ulcer, shearing forces, spinal cord injury
Urologic No underlying causes
Miscellaneous Amyloidosis, decubitus ulcer, friction, low weight, Marjolin's ulcer, prolonged immobilization, sarcoidosis

Causes in Alphabetical Order


  1. "Differential diagnosis of leg ulcers - Dissemond - 2006 - JDDG: Journal der Deutschen Dermatologischen Gesellschaft - Wiley Online Library". Retrieved 12 July 2013.
  2. "http://www.health.wa.gov.au/woundswest/docs/WPR_Nov09_Atypical_Leg_Ulcers.pdf" (PDF). Retrieved 12 July 2013. External link in |title= (help)