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07/09/2023Photodynamic therapy in dermatology
12/09/2023Skin ulcers are a disintegration of skin tissue and appear as open sores. They are referred to as ulcers when the process of re-epithelialization (skin regeneration) has failed for one of many potential reasons. Ulcers can occur anywhere on the body.
Forms of skin ulceration include decubitus or pressure ulcers (pressure sores); diabetic ulcers of the foot; ulcers of the oral cavity (gingival ulcer, aphthous ulcer); ulcers of the eye (corneal ulcer); vascular ulcers (venous ulcer, varicose ulcer, stasis ulcer, arterial ulcer, mixed ulcer), and genital ulcers (venereal ulcer).
Description
Ulcers can be categorized as follows:
- Those related to neoplasms, decubitus or pressure ulcers, and neurological problems, including those of diabetic origin which usually affect the lower extremities
- Vascular ulcers
Ulcers are then distinguished into acute and chronic depending on the duration of the inflammatory process.
Causes
The mechanism of how ulcers form varies depending on their location.
Vascular ulcers can arise following even modest trauma that triggers tissue loss. Other causes of skin ulceration are epithelial tumors, vascular diseases, and autoimmune diseases that affect the vascular system. In vascular ulcers, the slowing of blood flow in peripheral areas, usually the lower limbs, results in tissue damage.
Decubitus or pressure ulcers (pressure sores) are caused by a lack of adequate blood supply to an area and generally occur in patients who are bedridden for a long period.
Ulcers in diabetic people are neuropathic in origin. They are often located in the foot and are caused by an alteration in blood flow and tissue oxygenation.
Symptoms
The common symptom of all ulcers is pain. Following mechanical, chemical or infectious trauma, the deep layers of the epithelium are exposed to inflammatory and irritative processes causing a great deal of discomfort.
Ulcers can cause:
- Pain
- Swelling (edema)
- Redness
- Bleeding
Diagnosis
Cutaneous and vascular ulcers require the following examinations for a diagnosis to be made:
- echo color doppler (ECD), arteriography and phlebography
- blood tests to assess blood glucose and protein
Treatment
The treatment of ulcers will depend on the cause that was identified during diagnosis. Skin ulcers should be treated with antiseptic solutions, compression with an elastic bandage, use of healing (PEG Ointment) and re-epithelializing ointments, photodynamic therapy, use of epithelial growth factors.
Prevention
Ulcers can be prevented by following a healthy lifestyle, including a balanced diet that is rich in fiber, fruits and vegetables. In addition, drinking plenty of water, exercising regularly and avoiding smoking and drinking alcohol can also help. Finally, ensure the skin is properly hydrated by using the self-moisturizing Extreme Emollient Ointment.