ulcerationer

Ulceration, or ulcerations, refers to the formation of an open sore where tissue has died or been lost, typically involving the epidermis and often extending into deeper layers. Ulcerations can affect skin or mucous membranes and may be acute or chronic. They differ from erosions in depth and healing pattern and can arise from a wide range of causes, including reduced blood supply, infection, inflammation, pressure, trauma, or malignant processes.

Common causes and risk factors include pressure injuries from prolonged immobility, venous insufficiency leading to leg ulcers, arterial or ischemic ulcers from poor blood flow, diabetic foot ulcers, and mucosal ulcers in the mouth or gastrointestinal tract. Infections (such as bacteria or fungi), inflammatory or autoimmune diseases (for example vasculitis or Crohn’s disease), and exposure to certain medications (like nonsteroidal anti-inflammatory drugs) can also contribute. Chronic wounds may arise when healing is impaired by poor nutrition, diabetes, smoking, obesity, or repeated trauma. Ulcerations can also be malignant, or develop as a complication of radiation therapy or metastasis.

Pathophysiology involves tissue necrosis due to ischemia, infection, or ongoing inflammation, followed by a healing deficit that prevents re-epithelialization. Clinically, ulcers present as an open lesion with variable depth, discharge, crusting, pain, and surrounding skin changes. Diagnosis relies on history and physical examination, wound assessment, and, when indicated, imaging, wound culture, or biopsy to identify infection or rule out malignancy.

Management centers on treating the underlying cause and providing appropriate wound care. This includes debridement when needed, infection control, moisture-balanced dressings, compression for venous ulcers, revascularization or vascular care for arterial ulcers, glycemic control, nutrition, and pain management. Prognosis varies with cause and comorbidity; chronic ulcers carry risks of infection, osteomyelitis, sepsis, and, in long-standing wounds, malignant transformation in some cases (Marjolin’s ulcer).