If you have an open sore on your leg or foot that doesn't seem to heal, it could be a skin ulcer. Only your doctor will know for sure, though, so it's important to have it evaluated.

Symptoms of Leg Ulcers

Common symptoms of an ulcer on skin on lower body parts can include swelling of the leg, itching or burning, pain (although some ulcers may be painless), a rash, red or darkened skin, and scaly skin. But different kinds of leg and foot ulcers can present a little differently, so make a note of any unusual appearances on your skin and legs.

Leg Ulcer Causes

"The most important thing to know about ulcers is that they are manifestations of different disease processes and accordingly have quite different treatment pathways," explains Kurtis Kim, MD, a vascular surgeon with Mercy Vascular Center in Maryland. Some of the causes of skin ulcers include poor circulation, inflammatory disorders, diabetes, heart disease, high blood pressure, and a history of smoking, among other things.

Types of Skin Ulcers

Many skin ulcers affect the lower part of the body and fall into one of the following three categories:

  • Venous ulcers: Also called stasis leg ulcers, these occur when the veins in your legs don't function properly. In this instance, instead of circulating the blood from your legs back to your heart, it pools in place in your lower leg area, causing an open sore that often forms near the ankle. The tissue surrounding a venous ulcer will usually be a dark red or purplish color and the skin in that area may be especially dry and itchy. Pain is usually mild with this type of ulcer and can be relieved by elevating your affected leg.

  • Arterial ulcers: When your arteries become narrowed or blocked, this can damage your tissue and lead to arterial (also called ischemic) ulcers. These most often affect the top of the foot, heel, or toes. They may be yellow, brown, black, or gray in color with a "punched out" look around the edges. The area may also appear quite shiny with very thin skin and can be very painful, especially at night when you lie down.

  • Trophic ulcers: Trophic ulcers occur on the feet or other pressure points and are caused by circulatory problems, disease (such as diabetes), or trauma to the area that leads to inadequate nutrition to the tissue and results in the open sore. This type of ulcer typically doesn't cause pain, making it important for people at risk to have their feet and legs thoroughly examined by their healthcare provider on a regular basis.

Treating Skin Ulcers

"Regardless of the cause, it's important to recognize ulcers on the skin early, and treat them appropriately, by specialists such as vascular surgeons and podiatrists," says Kim. Evaluating an ulcer to get a proper diagnosis can be done through a physical examination, along with some imaging tests including an X-Ray, CT scan, and MRI.

The method of treatment will depend on the type of leg or foot ulcer and it's exact cause. Some common approaches include good wound care (vigilant cleansing to protect against infection), reducing pressure to the area (such as through compression stockings), using antibiotics if an infection exists, and evaluating the situation to determine if stenting, bypass, or other strategies are needed to improve blood flow in the body.
"In most cases, effectively treating ulcers in the leg involves all levels of healthcare professionals from primary care physicians to surgeons," Kim adds.

Kurtis Kim, MD, reviewed this article.

 

Sources:

Cleveland Clinic. "Diseases and Conditions: Lower Extremity (Leg and Foot) Ulcers." Nov. 2010. Web. 21 Jan. 2013.
http://my.clevelandclinic.org/heart/disorders/vascular/legfootulcer.aspx

Kim, Kurtis, MD. Vascular surgeon, Mercy Vascular Center, Baltimore, Maryland. Email interview 16 Jan. 2013.
http://www.mdmercy.com/centerExcellence/vascular/aboutPhysicians.html