Venous Skin Ulcer

Symptoms

Venous skin ulcers typically develop on the inside of the lower leg, above the ankle bone and below the calf. Less frequently, they develop on the outside of the lower leg. See an illustration of areas affected by venous skin ulcers.

The first sign of a skin ulcer is the appearance of dark red or purple skin over the affected area. It may also become thickened and dry and itchy. Contact your doctor if you have any of these warning signs.

Without treatment, an open wound (ulcer) may form. Venous skin ulcers often weep clear fluid and are covered with a yellowish film. The ulcer's edge is typically ragged, and the skin around it often thickens and turns reddish brown in color. You may also have:

• Pain, although it is not always present.
• Swelling and aches in the legs that are worse at the end of the day and when standing and are relieved when the legs are elevated above the level of the heart.
• Sensitized skin. The skin around the affected area becomes susceptible to rashes from topical medicines, perfumes, and other ingredients in creams and lotions (contact dermatitis).

Because venous skin ulcers are a result of poor circulation, these wounds are often slow to heal. Contact your doctor when you first notice the signs of a venous ulcer because you may be able to prevent an ulcer from forming. If an ulcer has already formed, get immediate treatment because smaller ulcers that have not been present long tend to heal faster than larger ones.

If an ulcer becomes infected, there may be an odor, pus draining from the wound, and increased tenderness and redness. Call your doctor if you have signs of infection.

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Author:	Maria G. Essig, MS, ELS	Last Updated: September 17, 2007
Medical Review:	Kathleen Romito, MD - Family Medicine Randall D. Burr, MD - Dermatology
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