Skin Ulcers: Causes, Symptoms, Types and Treatment Options

A skin ulcer is basically a form of sore that results due to improper blood circulation. 

Alteration in flow of the blood or simply improper circulation doesn’t heal the injuries properly which can transform injuries into ulcers. Sometimes ulcers might attract bacterial growth and lead to infection.

Ulcers of skin are commonly seen on mouth, feet, legs, hips, and back unlike gastric ulcers which are seen on the gastric lining of the stomach. Moreover, the most common ulcers are found on legs, with almost every 3 people among 1000 are diagnosed with leg ulcers.

Damage to the skin and open sores coupled with inflamed tissue that doesn’t heal properly often leads to skin ulcers.

Common causes of skin ulcers

The most common causes responsible for causing ulcers are: Infection due to injury or bacterial growth, Simultaneous pressure on one part, Damage to nerves and blood vessels, Improper blood circulation, Exposure to extreme conditions or material, Imbalance in diet and nutrition and finally, conditions like diabetes and atherosclerosis. 

Factors that pose a risk of developing skin ulcers: 

There are several factors that are responsible for development of ulcers. They are: 

Signs in addition with symptoms of skin ulcers: 

The experience of signs and symptoms that a patient with skin ulcers reports is 

1. Firstly, redness surrounding the ulcers  
2. Then, inflammation of the affected part, along with tenderness and itching 
3. Oozing of pus like fluid from the sores 
4. After that, alterations in texture of the affected skin 
5. Lastly, pain in and around the ulcers. 

These are the few signs and symptoms that relate to ulcers of the skin. 

Types/categories of skin ulcers: 

Categories or types of skin ulcers depend on multiple causes and divides into four types. For example, they are decubitus ulcers, venous, neuropathic ulcers and arterial ulcers. 

1. Decubitus ulcers: These are also known as pressure ulcers or pressure sores. Such types of ulcers results when continuous or simultaneous pressure and friction is exerted on the particular part. Above all, the common areas where decubitus ulcers are seen are back, hips, ankles, and heels. 
2. Neuropathic ulcers: As the name suggests, neuropathic means damage or dysfunction of the nerves. An ulcer that occurs due to nerve damage is neuropathic ulcer. The most common areas that a neuropathic ulcer affects are areas where the pressure falls on the foot including heels and toes of the feet. Additionally, people with diabetes often suffer from nerve damage and therefore neuropathic ulcers affects 15% of the people suffering from diabetes. 
3. Venous ulcers: Disruption and alteration of blood circulation in the veins leads to venous skin ulcers. The common affected areas of legs are starting from knees up to the ankles. And incidentally, venous ulcers comprise of almost 90% of the leg ulcer cases. 
4. Arterial ulcers: It is otherwise known as ischemic ulcers. Arterials ulcers results when arteries remain clogged and blocked due to multiple reasons. Moreover, the blockage of arteries leads to alteration in blood flow. These ulcers are seen on feet, ankles, toes and heels. Moreover, the important factor is that arterial ulcers lead to intense pain. 

Less common types of skin ulcers are stasis dermatitis and Buruli ulcer. 

1. Stasis dermatitis: It usually affects legs. In this condition, infected area of leg shows inflammation and irritation. The other name for this type of ulcer is gravitational dermatitis.  
2. Buruli ulcer: It is a type of ulcer that results due to infection by bacteria Mycobacterium Ulcerans. It affects both arms and legs. Above all, delay in diagnosis and treatment can transform Buruli ulcer into permanent physical deformities. 

How to diagnose ulcers of the skin? 

The main steps that a clinician employs in diagnosing ulcers of skin are 

1. First the clinician checks and examines the part or area where the ulcers begin, to determine the size of the sore, whether it contains pus or blood and any signs of bacterial growth. 
2. Lastly, after physical examination, doctors advise several tests including blood tests, CT scans and MRI along with tissue and pus or fluid culture tests to confirm the diagnosis of the ulcers. 

Treatment interventions suggesting how to heal skin ulcers: 

Skin ulcers treatment is based on the symptoms an individual shows because symptoms differ from patient to patient. However, the main goal of the treatment is to treat the ulcer and reduce pain and infection. 

1. Generally, patients with skin ulcers sometimes report inflammation. For such individuals, doctors recommend treatment with anti-inflammatory agents. 
2. In individuals with alteration or improper blood flow, a proper traditional approach i.e. leg elevation helps in improving blood flow. 
3. Moreover, if poor circulation leads to formation of ulcers, then employing compression socks can improve circulation. 
4. However, in cases of ulcers present on the leg, hyperbaric oxygen treatment is effective in preventing amputation and is confirmed through multiple studies. 
5. Lastly, Electrical stimulation also plays an important role in accelerating the process of healing of ulcers of the skin. 

The above table mentions about the treatment strategies that a clinician employs for treating ulcers. 

What role does stem cell therapy play in skin ulcers treatment? 

Stem cell therapy is one of the most promising therapies in wound healing. Firstly, wound healing is a complex process and requires integration with fibroblasts, and keratinocytes. Above all, Mesenchymal stem cell treatment is effective in conditions like diabetic wounds, and hypertensive and venous ulcers.  

• Firstly, when we incorporate stem cells, they travel to the wound site.  

• After migration, they differentiate into cells which help in the regeneration and restoration of damaged tissue. Additionally, they also produce factors for growth and cytokines. Thus, the released substances promote reduction of inflammation along with angiogenesis.  

Healthcare providers isolate PRP from the patient’s cells as Plasma-rich platelets encourage healing with its rich ability to secrete cytokines and growth factors. Hence, clinicians view PRP as the potential option in treating and healing wounds or sores. 

The role of nutritional supplements in skin ulcers

To begin with, in situations where a patient reports poor circulation, folic acid supplements help in improving poor circulation. Secondly, to ensure that the ulcers of the skin heal efficiently, incorporate diet rich in protein and moderate intake of calories. 

Zinc along with copper is important in tissue growth, so supplements containing a combination of zinc and copper can be helpful in healing ulcers. 

To accelerate process of healing of wounds, take supplements containing Vitamin C. And lastly, Vitamin E is also important in accelerating healing mechanism of ulcers. 

Ulcer Treatment Success Stories

Conclusion

Skin ulcers are a form of sores that result from improper blood circulation and are commonly seen in areas like arms, legs, heels, ankles, etc. Similarly, there are certain causes which lead to ulcers of the skin that range from vascular diseases to continuous pressure and improper blood circulation. However, skin ulcer symptoms vary depending upon the type of ulcer, severity and area affected.  

The only treatment goal is to accelerate healing and prevent further damage. For instance, there are several options for skin ulcer treatment, with regenerative medicine slowly establishing itself in the field of wound healing. Moreover, Plasma-rich platelets (PRP) generate certain factor which promotes healing. Therefore, skin ulcers are treatable if diagnosed early. 

FAQ’s

Q: How do you define skin ulcer? 

A skin ulcer is basically a form of sore that results due to improper blood circulation. Alteration in flow of the blood or simply improper circulation doesn’t heal the injuries properly which can transform injuries into ulcers. 

Q: What are the common causes that are responsible for ulcers of the skin? 

The most common causes responsible for causing ulcers are infection due to injury or bacterial growth, simultaneous pressure on one part, damage to nerves and blood vessels, improper blood circulation, and finally conditions like diabetes and atherosclerosis in addition to others. 

Q: What are the different types of skin ulcers? 

The different types of ulcers are decubitus ulcers, venous ulcers, neuropathic ulcers and arterial ulcers and less common types are stasis dermatitis and Buruli ulcer. 

Q: How does PRP treat ulcers? 

Plasma-rich platelets secrete cytokines and growth factors. And the released substances promote reduction of inflammation along with angiogenesis which treats ulcers.