A persistent open sore, usually on the lower part of the leg
A leg ulcer occurs when an area of skin on the lower leg breaks down, usually as a result of poor blood circulation. An open sore may then develop, either spontaneously or following a minor injury, such as a scratch by a fingernail.
An ulcer appears as a shallow, pink area of broken skin; the surrounding skin may be swollen. Ulcers are slow to heal and often painful. They are most common in older people who have poor circulation or are not very mobile.
There are two main types of leg ulcer: venous ulcers and arterial ulcers. More than 9 in 10 of all leg ulcers are venous ulcers, which are caused by poor blood flow through the veins and therefore often occur in people with varicose veins. The ulcers usually form just above the ankle and may be surrounded by purplish-brown, scaly skin.
Arterial ulcers develop as a result of poor blood flow through the arteries supplying the limbs. People with diabetes mellitus and those with sickle-cell disease are especially susceptible to this type of ulcer. Arterial ulcers often form on the foot and are surrounded by pale, thin skin.
At the first sign of an ulcer, you should consult your doctor. Leg ulcers often become infected, and the infection may spread to the surrounding skin, causing cellulitis.
Your doctor may recommend Doppler ultrasound scanning to assess blood flow in the affected leg. The ulcer should be dressed regularly and firmly bandaged to reduce swelling and improve blood circulation. Special dressings that promote healing may be prescribed. Wearing support stockings, exercising regularly, and keeping the leg raised when you are resting can also help to improve the circulation of the blood. If you have an arterial ulcer, you may need surgery to improve blood flow through the arteries.
In susceptible people, leg ulcers may take months to heal, and they often recur. Rarely, skin grafting may be needed. You should not neglect even minor wounds. Consult your doctor at the first signs of soreness in a leg.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.