Atypical Ulcers: Diagnosis and Management

Figures & data

Table 1 Systemic and Local Therapies for Atypical Wounds

Etiologies	Local Therapies	Systemic Therapies
Inflammatory ulcers	Non-adherent dressings, autolytic and enzymatic debridement, absorbent dressings, anesthetic cream, compression bandaging	Corticosteroids, immunosuppressants, biological therapies
Vasculopathies	Non-adherent dressings, autolytic and enzymatic debridement, absorbent dressings, compression bandaging	Anticoagulants, antiplatelets, pentoxifylline
Neoplastic ulcers	Surgery, radiotherapy, electrochemiotherapy, palliative dressings based on WBP*	Adjuvant and neoadjuvant therapies
Hematological ulcers	Non-adherent dressings, enzymatic and autolytic debridement, absorbent dressings	Hydroxyurea, blood transfusion, hyperbaric therapy
Infectious ulcers	Silver dressings, PHMB** dressings, iodine dressings, binding bacteria dressings, secondary dressings	Antibiotics, antimycotic, antiparasitic drugs
Hydroxyurea- induced ulcers	Dressings based on WBP*, compression bandaging	Drug suspension or replacement, prostaglandinE1, pentoxifylline
Heroin induced ulcers	Silver dressings, PHMB** dressings, iodine, binding bacteria dressings, compression bandaging	Antibiotics

Notes: *Wound bed preparation. **Polyhexamethylene biguanide.

Figure 1 (A) Pyoderma gangrenosum (Inflammatory ulcer), (B) Calciphylaxis (Vasculopathy), (C) Adamantinoma (Neoplastic ulcer), (D) Mycobatteriosis (Infectious ulcer), (E) Hydroxyurea-induced ulcer (F) Heroin induced ulcer.

Figure 2 Leg vasculitis: The blue ring indicates the selected lesion for the biopsy because of an early and untreated lesion.