Causes and risk factors:
Formation of ulcer is seen in patients who have a history of high and uncontrolled blood pressure. It is also seen in association with diabetes mellitus. Studies have shown that in a few cases there has been a history of trauma too. Lack or poor blood supply due to narrowing of blood vessels also contribute to the same.
The patient presents with ulcer formation. They are characteristically seen on the lower extremity. Supramalleolar region and anterolateral regions are the commonest sites affected. Single and symmetrical lesions are seen. On examination an irregular shaped, reddish purple color, deep ulcer with necrotic border is seen. Sometimes the underlying tendons are exposed. The patient comes up complaining of pain at the affected site. The pain is typically of a burning type and is extreme. It is out of proportion for the size of the ulcer present. Ulcers on the legs cause pain while walking.
Diagnosis and investigations:
The symptoms narrated by the patient and the local examination carried out by the doctor can help in diagnosing the case. The vital parameters are monitored. There is a history of hypertension. Routine blood test with increase white blood cells and C-reactive protein aids in diagnosis. Skin biopsy can also be done. Certain other tests are done to rule out other diseases.
Controlling the uncontrolled hypertension is the main line of treatment. Pain relievers along with non-steroidal anti-inflammatory drugs are given. In a few cases, antibiotics along with sympathectomy can also be done. In large and severe cases, surgical debridement along with compression therapy is needed. This is followed by skin grafting.
Other modes of treatment:
The other modes of treatment can also be effective in treating the pain. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivatives can also be beneficial in combating with the complaints.