45yrs old euglycemic painful ulcer left leg two weeks. Diagnosis and management



Venous ulcer with secondary infection Venous stasis and dermatitis. Varicose veins are visible. A colour Doppler study of lower limb vessels to confirm the diagnosis of varicose veins and status of deep veins. Treatment- Antibiotics- Augmentin Duo 1 gm B.D for 10days . Improve blood flow to lower limb vessels with tab cilostazol 50 mg B.D. Local debridement followed megaheal gel dressings. May requires SSG . Definitive treatment- Laser endovascular ablation or surgical treatment

Eugenic adult patient with ulceration at shin, dry rough brownish pigmented skin all around are most likely due to VENOUS STASIS DERMATITIS. AVOID : Long standing or sitting, trauma, topical antibiotic like neomycin due to possible hypersensitivity, topical calamine as it causes dryness. INVESTIGATIONS : Doppler USG of lower limb, Blood sugar. TREATMENT : 1. Oozing if any to be wiped off with gauze. 2. Topical mid potent steroid or tacrolimus 3. Oral Doxycycline 4. Oral antihistaminic if itching 5. Compression stockings (only if no arterial stasis as par doppler study report) 6. Allogeneic skin graft may be needed

History is incomplete Any trauma/accident... Varicose veins+venous ulcer (unhealthy tissue) Edge- slopping edge is there Investigation- venous Doppler study to r/o DVT Daily dressing, Antibiotics, diclo+serratiopeptidase drug, After seeing report can decide treatment

Eusol dressing for first 3 days after use comupimet granuleswith Italy antibiotics and symptomaticaly fr pain

Venous ulcer with secondary infection

Stasis dermatitis

Venous ulcer Colour doppler study of lower limb Tab augmentin 1 gm bjd Tab aceclo +para+serratopep 1 tds Daily dressing

Venous Ulcers Broad Spectrum antibiotics As dressing Raise the leg while lying

Venous ulcer and cellulitis

Ulcer will heal only if Varicose veins are treated. Stasis ulcer

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