Ulzeration

Ulceration, sometimes spelled ulzeration, refers to the process by which an ulcer forms or a surface tissue breaks down and exposes underlying tissue. An ulcer is a full-thickness loss of surface tissue with surrounding skin or mucosa often inflamed. The term originates from Latin ulcus, a sore, and is used across medical disciplines to describe tissue loss in skin, mucosa, or other organ linings.

Ulceration can result from ischemia, infection, inflammation, mechanical pressure, trauma, neoplasm, or vasculopathy. Common types include peptic ulcers of the stomach or duodenum, venous stasis ulcers of the lower leg, arterial (ischemic) ulcers, pressure ulcers from prolonged immobility, diabetic foot ulcers, mucosal ulcers in the mouth or genital tract, and corneal ulcers. The specific presentation and location are influenced by the underlying cause and affected tissue.

Pathophysiology involves disruption of the epithelial barrier, tissue necrosis, and inflammatory responses that impair healing. Chronic ulcers may exhibit necrotic tissue, granulation tissue, and scar formation. When ulcers persist or worsen, they may signal an underlying condition such as infection, malignancy, vascular insufficiency, or systemic disease.

Diagnosis relies on history and physical examination, with wound assessment and targeted tests (cultures, imaging, or biopsy) as indicated to identify infection, malignancy, or vascular problems. Management aims to treat the root cause, improve tissue perfusion when needed, offload pressure, control infection, debride necrotic tissue, and provide appropriate wound care to promote healing. Nutritional status and disease-specific factors (such as glycemic control in diabetes) are important for recovery.

Prognosis varies by etiology, chronicity, and comorbidity. Some ulcers heal with appropriate therapy, while others persist, requiring ongoing care and, in certain cases, surgical or vascular interventions.