Male with no history of varcisoe veins. Doppler normal. Lesion of the medial aspect of foot. What is the differential diagnosis?

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D/D.. ? NONHEALING VENOUS ULCER.. ? DIABETIC FOOT / ULCER.. ? PYODERMA GANGREOSUM.. ? MALIGNANCY.. NEED'S..CLINICOPATHOLOGICAL EVALUATION WITH.. * BLOOD CBC CT BT PT.. * URINE ROUTINE.. * BSR..HBA1C.. * SWAB C AND S EXAMINATION.. * HPE..BIOPSY.. * COLOUR DOPLAR STUDY.. MEANWHILE TREAT SYMPTOMATICALLY..
I cud c dilated tortuous veins in d pic, medial malleolar ulcers r classical venous ulcer. Sclerotherapy will certainly help in wound healing. If the ulcer is painful, thn I wud r/o vasculitis.
Pyoderma gangrenosum an ulcerating skin disease associated with inflammatory bowel disease , rheumatoid arthritis, haematological malignancies
Tubercular ulcer , Diabetic ulcer
may be dibetic foot ulcer
Diabetes should be ruled out also job of the patient should be asked any h/o travel to Egypt to r/o Leishmaniasis
Management for this patient look like Diabetic ulcer treatment maggots therapy and Magnesium sulphate dressing
patient was non diabetic bu has a history of inflammatory bowel disease. let's see who gets the diagnosis now
venous doppler of the lower limbs is mandatory. we dnt hav to depend on h/o
To do biopsy from edge of ulcer even though it is Syndromic complex of IBD.
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