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Leg ulcers

A leg ulcer is an open sore that develops when the skin is broken and air or bacteria gets into the underlying tissues. It can be caused by a minor injury or an underlying disease that affects the veins in the legs. Leg ulcers are most common on the inside of the leg, just above the ankle. In most people, damage to the skin heals within days or weeks, but when the skin doesn’t heal, the area affected can get bigger and develop into an ulcer.

Causes of leg ulcers

Venous disease

About 80% of leg ulcers are caused by venous disease, when the veins aren’t working properly. This is most commonly triggered when the valves inside the veins are faulty. Healthy leg valves allow blood to flow up towards your heart as it circulates around your body. If the veins are faulty, the veins fail to stop blood flowing back into the legs. This can cause an increase of pressure in the veins that can eventually cause skin to be come thin and inflamed and increase the risk of a venous ulcer developing.

Arterial disease

This condition is similar to venous disease, but is caused by arterial disease that triggers poor blood circulation. It accounts for about 15% percent of leg ulcers. It’s caused by a blockage in at least one of the arteries in the leg. It restricts blood flow to underlying tissue and can result in an arterial leg ulcer.

Underlying conditions

Some leg ulcers are caused by underlying conditions such as diabetes, rheumatoid arthritis or some other rare conditions.

In some cases, more than one condition may contribute to the development of leg ulcers. Your GP can do tests to find out the cause.

Symptoms of venous leg ulcers

Signs that you may be developing an ulcer include:

  • Swollen ankles
  • Swollen or enlarged veins in the leg
  • A heavy feeling in the leg
  • Aching and pain in the legs when standing for a long period
  • Relief when the leg is elevated, exercised or compressed by bandages
  • Brown discolouration or staining on the skin
  • Irritated, red, scaly or flaky skin
  • Hardened skin or scabbing around the sore area

Complications of venous leg ulcers

Leg ulcers can become infected by bacteria. Signs of an infection include:

  • Worsening pain
  • Green or unpleasant, and sometimes foul-smelling, discharge from the ulcer site
  • Red, swollen skin around the ulcer
  • A high temperature

Diagnosing leg ulcers

Contact your GP immediately if you develop any of the above symptoms. He or she will carry out a physical examination and possibly other tests to establish the cause of the ulcer. This may include a test with a Doppler machine that checks the blood supply to your legs. In some cases, you may be referred to a vascular specialist for conditions affecting the blood vessels.

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