[Pathogenesis of therapy refractory ulcus cruris].
OBJECTIVE
The most common cause of leg ulcers ischronic venous insufficiency (CVI), found in 70-80% of cases. The aim of this study was to analyze the causes of chronic, non-healing leg ulcers in inpatients.


METHODS
101 patients with leg ulcers admitted to the Dermatology Clinic of the Ruhr University, Bochum, Germany, were examined. Standardized diagnostic procedures were used to search for CVI, arterial disease, vasculitis, polyneuropathy and diabetes mellitus.


RESULTS
CVI was found in 95% of the patients. Only 17% had isolated venous disease. In most patients we found a combination of two or more possible etiologic agents; most commonly (92%) arterial plus venous disease. Arterial disease was confirmed in 74% of the patients. A combination of 3 etiologic factors was found in 27%.


CONCLUSIONS
Non-healing leg ulcers are likely to have multiple etiologies. Thus extensive and complete diagnostic approaches are mandatory.
Stücker
M
M
Klinik für Dermatologie und Allergologie der Ruhr-Universität Bochum. M.Stuecker@derma.de
Harke
K
K
Rudolph
T
T
Altmeyer
P
P
D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000453:epidemiology; D015984:Causality; D003430:Cross-Sectional Studies; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D016523:Foot Ulcer / Q000453:epidemiology / Q000209:etiology; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007871:Leg Ulcer / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D011115:Polyneuropathies / Q000175:diagnosis / Q000453:epidemiology; D011446:Prospective Studies; D014647:Varicose Ulcer / Q000453:epidemiology / Q000209:etiology; D014657:Vasculitis / Q000175:diagnosis / Q000453:epidemiology; D014689:Venous Insufficiency / Q000175:diagnosis / Q000453:epidemiology