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Dermatology > Leg Ulcers > Flashcards

Leg Ulcers Flashcards

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Dermatology Board Prep flashcards
1
Q

what is a chronic leg ulcer?

A

open wound between knee and ankle that remains unhealed for more than 4 weeks

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2
Q

what are the most common type of leg ulcer?

A

venous > arterial > rheumatoid arthritis > diabetic (neuropathy) > mixed

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3
Q

who are leg ulcers common in?

A

IV drug users
elderly
diabetics
cardiovascular patients

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4
Q

are leg ulcers usually treated in or out of hospital?

A

usually in the community

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5
Q

what contributes to the cost of venous leg ulcers?

A

delay in assessment, diagnosis and ABPI measurements

delays in commencing compression or confidence in applying compression bandages

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6
Q

what else can cause similar symptoms to a leg ulcer?

A

vasculitis - vasculitic rash
malignancy
inflammation

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7
Q

order of assessment of a leg ulcer?

A

patient
leg
ulcer

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8
Q

relevant history for leg ulcers?

A 
steroids
smoking status
mobility
nutrition
cardio disease
home help
extent of pain
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9
Q

how can lack of mobility cause a leg ulcer?

A

muscle pump not in use so not pumping blood back up the leg causing it to leak out

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10
Q

are there any muscles in veins?

A

no

therefore varicose veins can develop if immobile etc as well as blood leaking out of vessels

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11
Q

what is lipodermatosclerosis?

A

woody, tethered, sclerotic skin in relation to venous hypertension?

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12
Q

what is venous dermatitis?

A

eczema secondary to venous hypertension

scaling around the ankle and visible veins in foot

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13
Q

where are each type of ulcer ulcers most common?

A

venous = gaiter area (highest pressure)
heel common place for pressure ulcer
toes = diabetic neuropathy

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14
Q

what is slough?

A

debris

dead skin cells, bacteria and exudate which can slow down healing

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15
Q

what does an arterial ulcer look like?

A

pale, hairless leg
sharp, punched out lesion
deeper
unusual/ulcerated toe region

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16
Q

what can mimic a leg ulcer?

A

necrobiosis lipoidoca

17
Q

what commonly causes vasculitis?

A

antibiotics

also results in widespread rash

18
Q

normal ABPI?

A

around 1
< 0.8 = vascular disease
>1.5 = calcification
0.8-1.3 = needs compression

19
Q

what can a venous ulcer be confused with?

A

BCC

if not healing with compression - think it might not be an ulcer

20
Q

how are ulcers investigated?

A

APBI
only swab if strong evidence of infection
Bloods (FBC, LFTs, U&Es, CRP)
patch testing if they also have bad eczema as treatment could be causing it
Duplex if needed

21
Q

how are venous ulcers treated?

A 
pain control
ABPI
Non-adherent dressing
de - sloughing (hydrogel, honey etc)
4 layer compression bandaging
leg elevation (above hip height)
22
Q

when are compression stockings used?

A

if small ulcer

after ulcer has healed as prophylaxis

23
Q

how quickly are ulcers aimed to be healed?

A

by 12 weeks

24
Q

how is slough removed?

A

honey, hydrogels

25
Q

how can a wound site be cleaned/prepared/dead skin removed etc?

A

autolytic - dressings etc
sharp debridement - scalpel/scissors
biological - maggots
surgical - removal of dead tissue under GA

26
Q

why is zinc paste used in maggot treatment?

A

to protect surrounding skin from exudate caused

27
Q

why is zinc paste used in maggot treatment?

A

to protect surrounding skin from exudate caused

28
Q

which dressings heal ulcers?

A

none

compression heals ulcers

29
Q

how should leg ulcers be washed?

A

warm tap water and soap substitute

because the wound isn’t sterile

30
Q

how is venous dermatitis managed?

A

emollients
patch testing
topical steroids
compression

31
Q

name 3 relevant diseases in management of leg ulcers

A

cardiovascular disease
diabetes
DVT

32
Q

what shape is aimed for when padding and bandaging a leg

A

cone

33
Q

how long do compression stocking last before they must be changed?

A

6 months

34
Q

what is pyoderma gangrenosum?

A

autoinflammatory disorder causing al large ulcer

35
Q

what are the signs and symptoms of vasculitis?

A

inflammation of blood vessels causing purpuric rash/pustules
sudden and painful
necrotic

Dermatology (38 decks)

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