Ulcers are healing wounds that develop on the skin, mucous membranes, or eye. Although they have many causes, they are marked by:

1. Loss of integrity of the area
2. Secondary infection of the site by bacteria, fungus or virus
3. Generalized weakness of the patient
4. Delayed healing

Contents 1 Etymology 2 Skin ulcer classification schemes 2.1 Raghavendra manual classification 2.2 Wagner's classification 3 Other locations 4 Pathology of ulceration 4.1 Causes 4.2 Types 5 References

Etymology

The word ulcer is first attested from ca. The Bacteria ( singular: bacterium) are a large group of unicellular Microorganisms Typically a few Micrometres in length bacteria have A fungus (ˈfʌŋgəs is a eukaryotic Organism that is a member of the kingdom Fungi (ˈfʌndʒaɪ A virus (from the Latin virus meaning Toxin or Poison) is a sub-microscopic infectious agent that is unable Muscle weakness (or "lack of strength" is a direct term for the inability to exert force with one's Muscles to the degree that would be expected given the individual's Healing, assessed physically is the process by which the cells in the Body regenerate and repair to reduce the size of a damaged or necrotic area 1400 CE, deriving from Old French ulcere, which came from Latin ulcus "ulcer", ultimately from the Proto-Indo-European base *elk-es- "wound". Old French was the Romance Dialect continuum spoken in territories which span roughly the northern half of modern France and parts of modern Belgium Latin ( lingua Latīna, laˈtiːna is an Italic language, historically spoken in Latium and Ancient Rome. ^[1]

Skin ulcer classification schemes

The skin is the largest organ of the human body. The skin is the outer covering of living tissue of an animal (or plant Classification systems are used to communicate the severity and depth of an ulcer. It is an easy way to communicate changes for the better, or worse.

Raghavendra manual classification

• Stage 1: *The skin is red. The underlying tissue is soft. The redness disappears with minor pressure.
• Stage 2: There is redness, swelling and hardening of the skin around the area. In medical parlance, swelling is the enlargement of organs caused by accumulation of excess fluid in tissues, called Edema. Sometimes there is blistering. Sometimes there is loss of the superficial skin.
• Stage 3: The skin becomes necrotic. Necrosis (in Greek Νεκρός = "dead" is the name given to unnatural Death of cells and living tissue. There may be exposure of the fat beneath the skin. Fats consist of a wide group of compounds that are generally soluble in organic solvents and largely insoluble in water The skin may be lost through all its layers.
• Stage 4: There is more loss of fat and more necrosis of the skin through to the muscle beneath. Muscle (from Latin musculus, diminutive of mus "mouse" is contractile tissue of the body and is derived from the
• Stage 5: Continuing loss of fat and necrosis of muscle below.
• Stage 6: Bone destruction begins with irritation of the bone, erosion of the bone cortex progressing to osteomyelitis. Bones are rigid organs that form part of the Endoskeleton of Vertebrates They function to move support and protect the various organs of the body produce Osteomyelitis is an Infection of Bone or Bone marrow, usually caused by Pyogenic Bacteria or Mycobacteria. There may be sepsis of a joint, pathologic fracture or generalized body infection, septicemia. Sepsis is a serious medical condition characterized by a whole-body inflammatory state (called a Systemic inflammatory response syndrome or SIRS caused

This staging system for rating ulcers, is designed to rate the severity of pressure ulcers

• Stage 1 - There is erythema of intact skin which does not blanch with pressure. Erythema is redness of the Skin caused by Capillary congestion It may be the heralding lesion of skin ulceration.
• Stage 2 - There is partial skin loss involving the epidermis, dermis, or both. Epidermis is the outermost layer of the Skin. It forms the waterproof protective wrap over the body's surface and is made up of stratified squamous Epithelium with The dermis is a layer of Skin beneath the epidermis that consists of Connective tissue, and cushions the body from stress and strain The ulcer is superficial and presents as an abrasion, blister, or wound with a shallow center. A blister is a small pocket of fluid within the upper layers of the skin
• Stage 3 - This is an entire thickness skin loss. It may involve damage to or necrosis of subcutaneous tissue that may extend down to, but not through, the underlying fascia. The ulcer presents as a deep crater with or without undermining of adjacent intact tissues.
• Stage 4 - Here there is entire thickness skin loss with extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures. Tendons, and joints may also be exposed or involved. A tendon (or sinew) is a tough band of Fibrous connective tissue that usually connects Muscle to Bone and is capable of withstanding tension A joint is the location at which two or more Bones make contact There may be undermining and/or sinus tracts associated with ulcers at this stage. A sinus tract is an abnormal channel leading from within Bones or other structures to the Skin surface sometimes this type of passageway is termed a Fistula

Wagner's classification

This classification system is intended to rate the severity of diabetic foot ulcerations

• Grade 0 - Skin with prior healed ulcer scars, areas of pressure which are sometimes called pre-ulcerative lesion or the presence of bony deformity which puts pressure on an unguarded point. Scars (also called cicatrices) are areas of fibrous tissue that replace normal Skin (or other tissue after injury
• Grade 1-A - The wound is superficial in nature, with partial or full-thickness skin involvement but does not include tendon, capsule or bone.
• Grade 1-B - As above, the wound is superficial in nature, with partial or full thickness skin involvement but not including tendon, capsule nor bone; however the wound is infected. The definition of this wound implies superficial infection without involvement of underlying structures. If the wound shows signs of significant purulence or fluctuation, further exploration to expose a higher grade classification of infection is in order. Pus is a whitish-yellow yellow or yellow-brown substance produced during Inflammatory responses of the body that can be found in regions of Pyogenic bacterial
• Grade 1-C - As above but with vascular compromise.
• Grade 1-D - As above but ischemic. In Medicine, ischemia ( Greek ισχαιμία, isch- is restriction hema or haema is Blood) is a restriction Because ischemia is a type of vascular compromise, the distinction between these two grades is often difficult to make.
• Grade 2-A - Penetration through the subcutaneous tissue exposing tendon or ligament, but not bone. The subcutaneous tissue or subcutis is the layer of Loose connective tissue directly underlying the Dermis. In Anatomy, the term ligament is used to denote three different types of structures Fibrous tissue that connects Bones to other bones
• Grade 2-B - Penetration through the deep tissues including tendon or ligament and even joint capsule but not bone. An articular capsule (or joint capsule) is an envelope surrounding a Synovial joint.
• Grade 2-C - As above 2B, but including ischemic
• Grade 2-D - As above 2C, but including infection
• Grade 3-A - A wound which probes to bone but shows no signs of local infection nor systemic infection. In Medicine, ischemia ( Greek ισχαιμία, isch- is restriction hema or haema is Blood) is a restriction
• Grade 3-B - A wound which probes to bone and is infected.
• Grade 3-C - A wound which probes to bone, is infected, and is ischemic.
• Grade 3-D - A wound which probes to bone characterized by active infection, ischemic tissues, and exposed bone.
• Grade 4 - Gangrene of the forefoot
• Grade 5 - Gangrene of the entire foot

Other locations

1. Inferior members: most ulcers of the foot and leg are caused by underlying vascular insufficiency. Please do not add warnings to this page about the pictures Wikipedia is not censored for taste and has a guideline preventing such warnings - WikipediaNo disclaimers in articles Please do not add warnings to this page about the pictures Wikipedia is not censored for taste and has a guideline preventing such warnings - WikipediaNo disclaimers in articles The skin breaks down or fails to heal because of repeated trauma. Treatment of physical trauma is described here and in First aid. Pressure of the nail can cause subungual ulceration. A nail is a horn -like structure at the end of an animal's Finger or Toe. These are most frequently seen in diabetics who have a very low potential to heal from injury. Diabetes mellitus (ˌdaɪəˈbiːtiːz or /ˌdaɪəˈbiːtəs/ /məˈlaɪtəs/ or /ˈmɛlətəs/ often referred to simply as diabetes ( Ancient Greek: grc

1. Sacrum and ischium
2. Mouth ulcer
3. Peptic ulcers: This includes ulcers of the esophagus, stomach, large and small intestine
4. Genitalia: May be penile, vulvar or labial. An oral ulcer (from Latin ulcus) is the name for the appearance of an open sore inside the mouth caused by a break in the Mucous membrane or the epithelium A peptic ulcer, also known as PUD or peptic ulcer disease, is an Ulcer (defined as mucosal erosions equal to or greater than 0 The esophagus or oesophagus (see American and British English spelling differences) sometimes known as the gullet, is an organ in In Human anatomy, the stomach is a J-shaped hollow muscular organ of the Gastrointestinal tract involved in the second phase of Digestion, following In Anatomy, the intestine is the segment of the alimentary canal extending from the Stomach to the Anus and in humans and other mammals consists The penis (plural penises, penes The vulva (from Latin, vulva, plural vulvae or vulvas; see etymology) is the region of the external genital organs Most often are due to sexually transmitted diseases
5. Eyes: corneal ulcers are the most common type. A sexually transmitted disease ( STD) or venereal disease ( VD) is an illness that has a significant probability of transmission between Humans See Corneal ulcers in animals for information about the condition in animals Conjunctival ulcers also occur.

Pathology of ulceration

Causes

The most common causes (not in order) are:

• Bacterial infection
• Viral infection
• Fungal infection
• Cancer - both 'primary' and 'secondary'
• Venous stasis
• Arterial Insufficiency
• Diabetes
• Rheumatoid Arthritis
• Amyloidosis
• Loss of mobility
• Hypertension
• Gastroesophageal reflux disease

Types

Some specific types of ulcers are:

• Peptic ulcer (of the stomach, esophageal cardium or duodenum)
• Mouth ulcer
• Pressure ulcer (decubitus)
• Crural ulcer (due to venous insufficiency or other causes)
• Hunner's ulcer (of the bladder caused by Interstitial Cystitis)
• Ulcerative colitis (of the colon)
• Curling's ulcer
• Cushing ulcer
• Arterial insufficiency ulcer
• Venous insufficiency ulcer
• Diabetic foot ulcer
• Corneal ulcer
• Vascular ulcer

References

1. ^ Online Etymology Dictionary's entry on ulcer.

An infection is the detrimental Colonization of a host Organism by a foreign Species. An infection is the detrimental Colonization of a host Organism by a foreign Species. Mycosis (plural mycoses) is a condition in which Fungi pass the resistance barriers of the human or animal body and establish Infections Classification Cancer (medical term Malignant Neoplasm) is a class of Diseases in which a group of cells display uncontrolled Diabetes mellitus (ˌdaɪəˈbiːtiːz or /ˌdaɪəˈbiːtəs/ /məˈlaɪtəs/ or /ˈmɛlətəs/ often referred to simply as diabetes ( Ancient Greek: grc Rheumatoid arthritis ( RA) is a chronic systemic autoimmune disorder that causes the Immune system to attack the Joints, where In Medicine, amyloidosis refers to a variety of conditions in which Amyloid Proteins are abnormally deposited in organs and/or tissues Hypertension, also referred to as high blood pressure, HTN or HPN, is a medical condition in which the Blood pressure is chronically elevated Gastroesophageal reflux disease ( American English and Canadian English) or Gastro-oesophageal reflux disease ( British English, Hiberno-English A peptic ulcer, also known as PUD or peptic ulcer disease, is an Ulcer (defined as mucosal erosions equal to or greater than 0 In Human anatomy, the stomach is a J-shaped hollow muscular organ of the Gastrointestinal tract involved in the second phase of Digestion, following In Anatomy of the Digestive system, the duodenum is a hollow jointed tube about 25-30 cm (10-12 in long connecting the Stomach to the Jejunum An oral ulcer (from Latin ulcus) is the name for the appearance of an open sore inside the mouth caused by a break in the Mucous membrane or the epithelium Bedsores, more properly known as pressure ulcers or decubitus ulcers, are Lesions caused by many factors such as unrelieved Pressure; friction In Anatomy, the urinary bladder is a hollow muscular, and distensible (or elastic organ that sits on the Pelvic floor in Mammals It is the Ulcerative colitis ( Colitis ulcerosa, UC) is a form of Inflammatory bowel disease (IBD Curling's ulcer is an acute Peptic ulcer of the Duodenum resulting as a complication from severe burns when reduced plasma volume leads to sloughing A Cushing ulcer is a Gastric ulcer produced by elevated Intracranial pressure. Venous ulcers (or varicose ulcers) are Wounds that are thought to occur due to improper functioning of valves in the Veins usually of the legs

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