ABSTRACT
This chapter presents the case study of a 26-year-old woman. A 26-year-old woman is referred by the orthopaedic surgeons for an urgent dermatology opinion. Three weeks previously she had sustained a lower leg laceration at work and had attended the accident and emergency department where the wound was cleaned and sutured. Within four days the sutures had dehisced, so she presented to her GP who prescribed a course of flucloxacillin. Two days later, with an enlarging ulcer and increasing pain, she attended the A&E once more. The concern was of potential extending necrotic infection, such as necrotizing fasciitis and she was taken to theatre for urgent debridement and commenced on intravenous vancomycin and gentamicin. There is marked erythema and swelling of the distal third of the right lower leg, ankle and proximal foot. There are two areas of ulceration: a smaller regularly shaped ulcer anteromedially, and a more irregularly shaped and larger ulcer extending posteriorly from the medial malleolus.
