An ulcer is a break in the continuity of the covering epithelium-skin or mucous membrane.

Factors causing delayed healing

• Anaemia
• Absence of rest
• Hypoproteinaemia
• Diabetes
• Malnutrition
• Irradiation
• Uraemia
• Neutropenia
• Ischemia
• Active infection

Discharge from an ulcer

Serous discharge	Healing ulcer
Purulent discharge	Spreading ulcer
Bloody discharge	Malignant ulcer
Discharge with bony spicules	Osteomyelitis
Greenish discharge	Pseudomonas infection

Investigations

• Haematological
• LFT/protein
• Blood sugar
• Montoux test
• Serological test for syphilis
• Biopsy
• Swab
• FNAC of enlarged lymph nodes
• Xray of the affected part

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