Leg ulcers are twice as common in women as in men and are a major burden on the health service. They affect 1% of the adult population. Of the causes, 50% are venous, 10% arterial and a 25% ‘mixed’ — due to venous and arterial disease. The remainder are due to rare causes.
1. When veins do not take back blood to the heart in the legs- Venous disease
Veins take blood to the heart from peripheral tissues/organs & arteries take blood to the peripheral tissues/organs from the heart .
Blood flow to the legs relies on the pumping action of surrounding muscles and the integrity of valves present in the veins.
This may be due to damaged valves in your leg veins(e.g. DVT), clotting disorder, or mere problems in closing valves at your birth-congenital valve incompetence
2. When blood is not pumped adequately to the legs from the heart- Arterial disease Smokers getting leg ulcers is mainly due to this reason.
Common medical conditions are Atherosclerosis, Buerger’s disease & polyarteritis nodosa
3. When blood carrying vessels themselves having problems- Small vessel disease
Common medical conditions are Diabetes mellitus, rheumatoid arthritis, vasculitis, sickle cell disease & hypertension.
4. When there is an infection
In developing countries like Sri Lanka, infections such as Tuberculosis & Fungal infections like mycetoma causing leg ulcers are also not uncommon to see.
5. When nerves in the lower limbs having problems- Neuropathy
Diabetes mellitus, leprosy & syphilis are known to affect nerves in the legs.
6. When there is
an abnormal growth of tissues in your legs- Neoplasia
If you are having a non-healing ulcer for a long term, be careful, it may be a cancer.
Medically speaking Squamous cell carcinoma, Kaposi’s sarcoma & malignant melanoma are important.
7. When there is a direct injury- Trauma
Dr. Yapa Wijeratne