ulceratie

Ulceration is the process of tissue loss from the surface of the skin or mucous membranes, resulting in an open lesion that extends beyond the epidermis. Ulcers can vary in size and depth and may be accompanied by discharge, pain, or bleeding. The term ulceration is used across medical fields, including dermatology, gastroenterology, and dentistry.

Causes are diverse and include local ischemia, pressure, trauma, infection, inflammatory or autoimmune disease, vascular insufficiency, and malignancy. Common examples are pressure ulcers, venous ulcers, arterial ulcers of the legs, mucosal ulcers in the stomach or mouth, and peptic or aphthous ulcers.

Pathophysiology involves disruption of tissue integrity with impaired healing. Initiating injury damages the epithelial barrier, followed by inflammation, necrosis, and attempts at re-epithelialization. Adequate blood flow, nutrition, and absence of ongoing injury or infection are essential for healing.

Diagnosis relies on clinical examination and history; internal ulcers may require imaging, endoscopy, or biopsy to determine cause and rule out cancer or infection. Laboratory tests may assess nutrition, glycemic status, infection, or inflammatory markers as appropriate.

Treatment targets the underlying cause and wound care. Management may include off-loading or compression, acid suppression or infection treatment, debridement of nonviable tissue, appropriate dressings, and, when needed, surgical repair or grafting. Prevention focuses on risk-factor modification and protective skin or mucosa care.