Trophic ulcers: symptoms

Trophic ulcers have characteristic symptoms. They are manifested by the appearance on the skin of a non-healing wound. Symptoms depend on the etiology of the disease, against which a trophic ulcer originated. The variety of reasons for the development of the syndrome requires the doctor to carefully collect anamnesis, scrupulous physical examination of all organs and systems of the patient, attract specialists of related specialties (dermatologist, rheumatologist, oncologist, hematologist, etc.). In addition to local skin-trophic changes, almost always to some extent, there are general symptoms, characteristic of the underlying disease. So, pyogenic trophic ulcers are characterized by signs of a systemic inflammatory reaction, in arterial - symptoms of intermittent claudication, with venous symptoms - symptoms of chronic venous insufficiency.

All skin trophic ulcers, although they have general patterns of development and healing, are not uniform in their origin, size, localization, depth, clinical course of the wound process, etc. These are dynamically changing entities that are subject to certain structural changes from the time of their education before healing. In the first stages, the wound cavity is filled with wound contents (transudate or exudate, detritus), then with granulation tissue and ultimately epithelium as a result of healing of the defect.

Signs, as a rule, take place in several stages. Initially, the skin is formed pathological focus with impaired skin microcirculation. Further, with minimal trauma, and in some cases spontaneously, there is actually a skin defect, characterized by the development of inflammation, necrosis of the skin and deeper tissues. Similarly, many venous, ischemic and some other trophic ulcers are formed. Pyogenic trophic ulcers are characterized by the formation of papules, infiltrates, then pustules, ectims or abscess and only then - ulcerative defect. With ulcerative necrotic vasculitis, gangrenous pyoderma, initially there are multiple polymorphic primary skin elements in the form of spots, erythema, hemorrhages, blisters with cyanotic coloring of the surrounding skin. All these pathomorphological skin changes and symptoms correspond to the first stage of the wound process. The duration of this stage is different, depends on the etiology of the disease and can last from 2 weeks, as with some piogenic ulcer defects, up to several months and even years, as with defects such as decubital, venous and ischemic trophic ulcers.

With a favorable course of the underlying disease and the wound process, either on its own or as a result of treatment there is a rejection of necrotic masses, relief of acute inflammation with proliferation of granulation tissue of varying degrees of maturity. These symptoms correspond to the II stage of the wound process. If optimal conditions for healing are ensured, the trophic ulcer ends with epithelization of the wound and reorganization of the scar, which corresponds to the third stage of the wound process.