Ulcus is the common medical term for a wound. With skin wounds, epidermis and parts of the dermis are damaged, resulting in an alteration of the skin that leads to loss or damage of skin tissue. Typically, there is a depression in the skin covered by a scab or blood.
Skin wounds can occur at any age, but they are most common in older individuals.
Wounds often cause pain, and there may be issues with fluid leakage and bleeding. The fear that the wound will not heal or that it isa serious skin condition can be distressing. A dermatologist can often determine the type of wound. The appearance of the wound will help the doctor make a diagnosis, so taking a photo of the wound when it is at its worst can be useful. A tissue biopsy is often useful in determining the cause of the wound and whether it may be something dangerous. Virus and bacterial tests are also often relevant.
Sometimes the causes of wounds are easy to understand, such as in cases of puncture wounds, corrosive injuries, trauma, burns, radiation damage, etc. Wounds that occur spontaneously over a longer period can be more challenging.
Leg and foot ulcers are common and are most often caused by disruptions in the blood supply to the skin, either in the arteries (arterial ulcers) or veins (venous ulcers). Typically, a small injury to the leg (abrasion) will result in a wound that does not close or heal properly due to poor blood supply. This can develop into a several centimetres large wound with crusts and fluid leakage. Arterial ulcers are typically located on the outermost part of the foot and are painful, while venous ulcers are found on the shin. Swelling in the legs is often a contributing factor in venous ulcers.
Skin cancer wounds are common. The most typical example is when basal cell carcinoma on the face causes wounds. These can grow over a few months or a longer period. A crusted wound is typical. All types of skin cancer can result in wound formation, including melanoma. If a brown or black spot or lump has ulceration and bleeding, it should be promptly examined and potentially removed by a doctor.
Infections can cause superficial wounds, often accompanied by fluid leakage and sometimes blisters. Herpes, both on the lips and genitals, causes blisters and small sores/cracks in the skin. Bacterial infections can also cause wounds. Fungal infections rarely result in skin ulcers.
There are several other rarer causes of skin wounds, such as diabetic ulcers, vasculitis, pyoderma gangrenosum, and bullous pemphigoid.
First, it is important to determine the type of wound before deciding on treatment. Cleansing the wound can be important. Wounds are open and are often infected with skin bacteria, so washing with sterile water is not necessary. Wounds can often be washed with tap water. Dead tissue, blood, and crusts should be removed, and a wound ointment should be applied before covering the wound with a dressing. Wound ointments can be purchased over the counter at a pharmacy. If the wound is moist and exuding fluid, an absorbent dressing should be chosen to draw away the fluid. However, if the wound is dry, a tight dressing may be more appropriate. Dressings should be changed daily in some cases, while in others, it is best to change the dressing every few days.
In the case of leg ulcers, a compression bandage is often used to reduce swelling and improve venous blood flow. For wounds caused by skin cancer, surgical treatment may be appropriate, but other treatment options are also available.
For certain types of wounds, immunosuppressive treatments or oral antibiotics may be the appropriate treatment. Skin wounds resulting from injuries such as cuts should typically be treated within a few hours at an emergency department. If such a skin injury is of a certain size, it is often beneficial to suture the wound.
