Examination

1- Sloping
Site Shape Size

Floor

Depth
The ulcer is shallow & the epithelium is
growing in from the edge in an attempt to
Edge (5 types) heal
 Examination 2- Punched-out

Edge (5 types)
1- Sloping or square cut:
cut It results from rapid death
& loss of the whole thickness of the skin
with minimal attempt of healing

Gamma of 3ry
Neuropathic ulcer in the
syphilis Leprosy sole of foot
 Examination 3- Undermined edge

Edge (5 types)
1- Sloping
When infection is affecting the subcutaneous
2- Punched-out
tissue more than the skin, the edge becomes
undermined

Undermined edge in diabetic foot infection

Tuberculous ulcer

Pressure bed sore in

the buttock.
Subcutaneous fat is more
Undermined edge in susceptible to pressure
Pyoderma gangrenosa than the skin
 Examination 4- Rolled
Edge (5 types)
1- Sloping

2- Punched-out
Develops when there is slow growth of
3- Undermined
tissue in the edge of the ulcer

Basal cell carcinoma (rodent ulcer):

Pale pink edge with clumps & clusters of cells visible through the
paper thin superficial covering of squamous cells
 Examination
5- Everted edge
Edge (5 types)
1- Sloping

2- Punched-out

3- Undermined
Develops when the tissue in the edge of the
4- Rolled ulcer is growing quickly and spilling out of
the ulcer to overlap the normal skin.
This edge is typical of carcinoma at any site

Malignant transformation in
Malignant ulcer colon
a chronic venous ulcer
carcinoma
“Marjulin” ulcer
 Examination
Site Shape Size

Floor

Depth

Edge
Purulent discharge from
Discharge infected bed sore

Serosanguinous discharge
May be: serous, sanginous,
from infected diabetic foot
serosanguinous or purululent
ulcer
A dry discharge forms a scab
that covers the ulcer

Dry scab covering the ulcer

 Examination
Site Shape Size

Floor

Depth

Edge

Discharge
Cellulitis around the ulcer
Skin (or tissues) around
Pigmentation around
venous ulcer

Hyperpigmentation of ch. Recurrent infection

 Examination
Site Shape Size

Floor

Depth

Edge
It is important to know if the
Discharge ulcer is adherent to the
Skin (or tissues) around
deep structures

Relations (adherent
to deeper tissues)
 Examination

Site Shape Size

Floor The draining LNs may be

enlarged 2ry to infection or
Depth
2ry to tumour deposits.
Edge
Infected LNs may be
Discharge tender

Skin (or tissues) around

Relations (adherent to deeper tissues)

Draining LNs