n 

ulcer is a sore on the skin or a mucous membrane, accompanied by the disintegration of

tissue. Ulcers can result in complete loss of the epidermis and often portions of the dermis and
even subcutaneous fat. Ulcers are most common on the skin of the lower extremities and in the
gastrointestinal tract. An ulcer that appears on the skin is often visible as an inflamed tissue with
an area of reddened skin. A skin ulcer is often visible in the event of exposure to heat or cold,
irritation, or a problem with blood circulation.
They can also be caused due to a lack of mobility, which causes prolonged pressure on the
tissues. This stress in the blood circulation is transformed to a skin ulcer, commonly known
as bedsores or decubitus ulcers.[1] Ulcers often become infected, and pus forms.

Contents

 1Signs and symptoms

o 1.1Discharges
 2Causes
 3Diagnosis
o 3.1Grading
 4Management
o 4.1Investigations
o 4.2Treatment
 5See also
 6References
 7External links

Signs and symptoms[edit]

Skin ulcers appear as open craters, often round, with layers of skin that have eroded. The skin
around the ulcer may be red, swollen, and tender. Patients may feel pain on the skin around the
ulcer, and fluid may ooze from the ulcer. In some cases, ulcers can bleed and, rarely, patients
experience fever. Ulcers sometimes seem not to heal; healing, if it does occur, tends to be slow.
Ulcers that heal within 12 weeks are usually classified as acute, and longer-lasting ones
as chronic.
Ulcers develop in stages. In stage 1 the skin is red with soft underlying tissue. In the second
stage the redness of the skin becomes more pronounced, swelling appears, and there may be
some blisters and loss of outer skin layers. During the next stage, the skin may
become necrotic down through the deep layers of skin, and the fat beneath the skin may become
exposed and visible. In stage 4, deeper necrosis usually occurs, the fat underneath the skin is
completely exposed, and the muscle may also become exposed. In the last two stages the sore
may cause a deeper loss of fat and necrosis of the muscle; in severe cases it can extend down
to bone level, destruction of the bone may begin, and there may be sepsis of joints.
Chronic ulcers may be painful. Most patients complain of constant pain at night and during the
day. Chronic ulcer symptoms usually include incre