ABSTRACT
The successful treatment of leg ulcers depends on accurate diagnosis, which itself depends on the examination and investigations described in Chapters 9-11. As in all branches of clinical medicine, experience is helpful, but a spot diagnosis
can often be inaccurate and sensible clinicians will arrange confirmatory investigations, even when they are 90 percent sure of the underlying cause of the ulcer. Most leg ulcers seen in the UK are venous or ischemic in origin. Infectious ulcers are more commonly seen in tropical countries; neoplastic ulcers are less frequent, but it is most important always to be aware of this possibility and there are a number of less common causes which are difficult to classify (Box 8.1). Ulceration associated with rheumatoid disease and diabetes is also frequently encountered. Examination must be directed to the site of the ulcer and the appearance of its base and edge, before examining the leg veins and pedal pulses.
