| Vascular disease |
- Venous: post-thrombotic syndrome, varicose veins, chronic venous reflux
- Arterial: peripheral arterial occlusive disease, hypertension, arteriovenous fistulas, arterial thrombosis, embolism, dysplasia, thromboangiitis obliterans, aneurysm
- Lymphatic: lymphedema
- Microangiopathy: diabetes mellitus, livedoid vasculopathy
- Vasculitis
- Hypertensive arteriolopathy
|
| Neuropathic |
- Peripheral neuropathy: diabetes mellitus, alcohol, medication, hereditary
- Central neuropathy: tabes dorsalis, myelodysplasia, syringomyelia, spina bifida, poliomyelitis, multiple sclerosis
|
| Metabolic |
- Diabetes mellitus, gout, prolidase deficiency, Gaucher disease, amyloidosis, calciphylaxis, porphyria, hyperhomocysteinemia
|
| Hematologic |
- Sickle cell anemia, thalassemia, polycythemia vera, leukemia, thrombocythemia, lymphoma, myeloplastic disorders, disorders of coagulation factors (factors I-XIII), coagulation inhibitors (antithrombin III, activated protein C resistance, protein C and S), or fibrinolysis factors (tissue plasminogen activator, plasminogen activator inhibitor, plasmin)
|
| Autoimmune |
- Rheumatoid arthritis, leukocytoclastic vasculitis, polyarteritis nodosa, Wegener granulomatosis, Churg-Strauss syndrome, systemic lupus erythematosus, Sjögren syndrome, scleroderma, Behçet disease, cryoglobulinemia
|
| Exogenous |
- Heat, cold, pressure, ionizing radiation, chemical, allergens, trauma
|
| Neoplasia |
- Basal cell carcinoma, squamous cell carcinoma (Marjolin ulcer), malignant melanoma, angiosarcoma, cutaneous lymphoma, papillomatosis cutis carcinoides, keratoacanthoma
|
| Infection |
- Bacterial: furuncles, ecthyma, mycobacterioses, syphilis, erysipelas, anthrax, diphtheria, chronic vegetative pyodermia, tropical ulcer
- Viral: herpes, variola virus, cytomegaly
- Fungal: sporotrichosis, histoplasmosis, blastomycosis, coccidioidomycosis
- Protozoal: leishmaniasis
|
| Medication |
- Hydroxyurea, leflunomide, methotrexate, halogens, coumarin, vaccinations, ergotamine, infiltration cytostatic agents
|
| Genetic defect |
- Klinefelter syndrome, Felty syndrome, TAP1 mutation, leukocyte adhesion deficiency, inherited hypercoagulable factors
|
| Skin disorder |
- Pyoderma gangrenosum, necrobiosis lipoidica, sarcoidosis, perforating dermatosis, Langerhans cell histiocytosis, papulosis maligna atrophicans, bullous skin diseases
|
Modified from Dissemond J, Korber A, Grabbe S. Differential diagnosis of leg ulcers. J Dtsch Dermatol Ges 2006;4:627-34.