The identification and diagnosis of malignant leg ulcers

Leg ulcers are predominantly managed by nurses working in primary care. One audit has suggested that 34 per cent of leg ulcer patients receive treatment without a documented diagnosis (Moffatt and Harper, 1997). Malignant leg ulceration is an uncommon condition but several recent reports suggest that its prevalence is increasing (Taylor, 1998; Yang et al, 1996). Tests such as tissue biopsy, which are required to exclude the less common causes of ulceration, are currently outside the role of the primary care nurse who has a vital part to play in referring patients to a specialist for further detailed assessment. This article raises awareness of the types of malignant leg ulcers and the clinical features associated with them.