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Case Study/Series
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Pathology and etiology of superfical cutaneous ulcerations First Author: Seth Forman Authors: Seth B. Forman, MD Tammie C. Ferringer, MD Dirk M. Elston, MD Cutaneous ulceration is a common chief complaint in dermatology practice. We present thirty-five consecutive cases of superficial cutaneous ulceration with a review of the corresponding pathology. Five of the ulcers revealed an underlying malignancy (two invasive malignant melanomas, two squamous cell carcinomas, one basal cell carcinoma.) Two cases were ulcerated premalignant actinic keratoses. Ten cases revealed benign melanocytic, vascular or epidermal tumors including melanocytic nevi, hemangiomas or seborrheic keratoses. Five cases of ulceration revealed a primary inflammatory disorder such as chondrodermatitis nodularis helicis, lichen sclerosus et atrophicus, hidradenitis suppurativa, or seborrheic dermatitis. There were two cases of neurodermatitis including prurigo nodules and lichen simplex chronicus. An infectious etiology such as gram positive cocci or verruca vulgaris was present in four cases. Two cases of ulceration of the distal extremities due to atherosclerotic disease resulted in amputation. Six cases of ulceration revealed no obvious underlying pathology. The aforementioned series illustrates the manifold underlying etiologies of superficial cutaneous ulceration. Most notably, twenty percent (7 cases) revealed malignant or pre-malignant tumors. Therefore, upon presentation an adequate biopsy is necessary to determine the ulcer's etiology. Upon recognition of the pathophysiology the proper clinical management can be initiated. |
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