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A very common and dangerous type of skin ulcer is caused by what are called pressure-sensitive sores, more commonly called bed sores, which are frequent in people who are bedridden or who use wheelchairs for long periods. [citation needed] Other causes producing skin ulcers include bacterial and viral infections, fungal infections [6] and cancers.
The skin surrounding a venous ulcer may be edematous (swollen) and there may be evidence of varicose veins; the skin surrounding an arterial ulcer may be pale, cold, shiny and hairless. Both venous and arterial ulcers may be painful, however arterial ulcers tend to be more painful, especially with elevation of the leg, for example when in bed.
Pressure ulcers can trigger other ailments, cause considerable suffering, and can be expensive to treat. Some complications include autonomic dysreflexia, bladder distension, bone infection, pyarthrosis, sepsis, amyloidosis, anemia, urethral fistula, gangrene and very rarely malignant transformation (Marjolin's ulcer – secondary carcinomas in chronic wounds).
Surgery to remove the basal-cell carcinoma affected area and the surrounding skin is thought to be the most effective treatment. [40] A disadvantage with standard surgical excision is a reported higher recurrence rate of basal-cell cancers of the face, [ 41 ] especially around the eyelids, [ 42 ] nose, and facial structures. [ 43 ]
The ulcer has punched-out appearance. It is intensely painful. It has gray or yellow fibrotic base and undermining skin margins. Pulses are not palpable. Associated skin changes may be observed, such as thin shiny skin and absence of hair. They are most common on distal ends of limbs.
In those with more severe disease, laser therapy or surgery to remove the affected skin may be viable. [2] Rarely, a skin lesion may develop into skin cancer. [3] If mild cases of HS are included, then the estimate of its frequency is from 1–4% of the population. [2] [3] Women are three times more likely to be diagnosed with it than men. [2]
Sores are not painful, but they may be itchy. Lymph nodes in the affected area may be swollen, but fever is rare. Touching or scratching the sores may easily spread the infection to other parts of the body. [12] Skin ulcers with redness and scarring also may result from scratching or abrading the skin. [citation needed]
Cutaneous leishmaniasis; Other names: Oriental sore, Tropical sore, Chiclero ulcer, Chiclero's ulcer, Aleppo boil, Delhi Boil or Desert boil [1] [2] [3]: A man with cutaneous leishmaniasis in the Middle East, known then locally as "Jericho Buttons" for the frequency of cases near the ancient city of Jericho