Ulcer

Introduction The ulcer is a defect caused by the destruction of the dermis or the deep woven of the skin, and there is a preservation mark after the healing, which is different from the erosion. Ulcers are secondary lesions, which can lead to ulcers in the case of skin damage, infection or nodular ulceration.

Cause

Skin ulcers are generally localized skin tissue defects caused by trauma, microbial infections, tumors, circulatory and neurological dysfunction, immune dysfunction or congenital skin defects. Traumatic ulcers are often caused by physical and chemical factors acting directly on tissues. Microbial infectious diseases are mostly caused by bacteria, fungi, spirochetes, viruses and the like. Nodules or tumor rupture. An vascular inflammatory ulcer caused by an immune abnormality is formed by necrosis of tissue due to arterial or arteritis. Circulatory or neurological dysfunction is a tissue disorder caused by nutritional disorders, such as varicose veins and leprosy ulcers.

(1) Bacterial diseases

Swollen, phlegm, cellulitis, sweat gland inflammation, skin tuberculosis, sore, skin anthrax, nasal discharge, skin diphtheria, necrotizing acne, squat pyoderma, leprosy, tropical ulcer, mycobacterial ulcer, Swimming pool granuloma, oral tuberculous ulcers.

(two) fungal diseases

Griposis, cutaneous cryptococcosis, histoplasmosis, ball basidiomycete, aspergillosis, foot swollen, actinomycosis, nocardiosis, jaundice, purulent, mucormycosis disease.

(3) Viral diseases

Hand, foot and mouth disease, foot and mouth disease.

(4) Parasitic diseases

Skin amebiasis, skin fly plague.

(5) Sexually transmitted diseases

Genital sores, syphilis, soft acne, granuloma, and sexually transmitted lymphogranulomatosis.

(6) Allergic skin disease Fixed drug rash.

(7) vasculitis and vascular diseases

Nodular polyarteritis, allergic vasculitis, thromboangiitis obliterans, papular necrotic tuberculosis, hard erythema, gangrenous pyoderma, fatal midline granuloma, wegener granulomatosis, arteriosclerosis obliterans , stasis dermatitis, Raynaud's disease.

(8) Physical diseases

Ray dermatitis, frostbite, hemorrhoids.

(9) Occupational skin diseases

Chromium, nickel, sodium, zinc, cobalt, hydrochloric acid, sulfuric acid, hydrofluoric acid, sodium hydroxide, sodium carbonate can cause skin ulcers.

(10) Autoimmune disease Behcet's disease.

(11) Tumor

Eczema-like cancer is eczema-like cancer and basal cell carcinoma. Squamous cell carcinoma, malignant melanoma, sebaceous gland carcinoma, chapter-like granuloma, malignant histiocytosis, kaposi sarcoma, hair sheath cancer, fibrosarcoma, proliferative erythema, squamous cell carcinoma, multiple plasmacytoma.

(12) Others

Continuous acral dermatitis, nodular fat necrosis, fatty granuloma, foot-through ulcer, aphtha stomatitis, gangrenous balanitis, acute female genital ulcer.

an examination

Related inspection

Serum iron (Fe) serum zinc (Zn) Mycobacterium tuberculosis serological examination (anti-TB)

(1) medical history

To understand the history of ulcer patients should be directed at the cause of ulcers, in general, should include the patient's age, gender, occupation and history of unclean sexual intercourse. Because ulcers are often secondary damage, it is especially important to understand the characteristics of the initial lesions in the current medical history, often providing diagnostic clues. It should also be aware of the location of the lesion, the speed of development, the changes, the period of illness and medication, and the past disease.

(2) Physical examination

Physical examination should pay attention to the patient's general condition and the location, distribution, size, number, color and edge of the ulcer. Shape, substrate and surface secretions.

(3) Laboratory inspection

Histopathology is a commonly used diagnostic method for the identification of tumors, vasculitis and general inflammatory ulcers. Bacterial culture and fungal examination can help diagnose the infectious diseases. For details, see the differential diagnosis.

Differential diagnosis

The diagnosis should be differentiated from the following symptoms:

1. Esophageal ulcer is an inflammatory lesion caused by different causes and occurs in various segments of the esophagus, that is, the mucosal layer of the esophagus, the submucosa and the muscle layer are destroyed. Specifically, it is an ulcer that occurs below the pharynx and above the dentate line.

2. Oral ulcers Oral ulcers: also known as recurrent aphthous ulcers, is a kind of recurrent oral mucosal disease. It is characterized by repeated attacks, burning and unbearable, and can cause a variety of complications. Dialectical discussion of Chinese medicine: recurrent oral ulcers are caused by internal injuries, weak body, and six senses of external sensation, resulting in liver qi stagnation, stagnation and heat, heart fire, stagnation of stomach fire, heart and kidney not paying, virtual fire On the inflammation and fumigation in the mouth and the disease.

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