Contactulcera

Contactulcera is a non‑infectious ulcerative condition that develops on the skin through prolonged contact with irritants, pressure or friction. It is distinguished from other ulcer types by its close relationship with external mechanical or chemical stimuli rather than underlying systemic disease. The lesion typically appears as a well‑defined erosion, often with ragged borders, and may be accompanied by mild inflammation or crusting. The condition is usually confined to surface layers and rarely progresses to deeper tissues unless the irritant continues.

The primary etiologic factors of contactulcera are chronic pressure, repeated friction, or continuous exposure to corrosive substances such as certain detergents or industrial chemicals. Patients with jobs that require prolonged manual work, or those who keep frequently used tools or equipment in contact with the skin, are at increased risk. Additional predisposing factors include impaired sensation, poor circulation, or skin integrity issues such as eczema or psoriasis. Pathophysiology involves a localized disruption of the epidermis, leading to loss of keratinocytes and dermal connective tissue. The wound environment is further aggravated by continued mechanical stress, preventing proper re‑epithelialization and leading to a persistent ulcer.

Clinically, patients present with a superficial ulcer that may be tender or painless. A characteristic feature is the ulcer’s clear demarcation from surrounding intact skin. Physical examination and history reveal recent or ongoing contact with a potential irritant. Diagnosis is largely clinical; microscopy and culture are indicated if superinfection is suspected. Differential diagnoses include pressure ulcers, traumatic wounds, and inflammatory dermatologic conditions.

Treatment focuses on removing the causative irritant and promoting a moist, non‑aggressive wound environment. Moist dressings, barrier creams, or silicone sheets help protect the area. If the ulcer is large or infected, systemic antibiotics may be required. Re‑education of work practices and ergonomic adjustments prevent recurrence. Early intervention is essential to avoid complications such as deeper tissue damage or chronic pain.

Epidemiologic data on contactulcera are limited, as surveys have rarely distinguished it from other mechanical wounds. However, occupational health studies indicate that it constitutes a notable portion of work‑related skin injuries. Ongoing research examines the molecular response of skin to chronic mechanical irritation, aiming to develop more targeted barrier agents to prevent ulcer formation.