Blood dyscrasias and leg ulcers

Despite a seemingly increased knowledge about the underlying causes of chronic leg ulcers, their management remains a challenge. Though some ulcers respond to various local treatment options appropriately, others seem to remain unresolved or with a chronic recurrent theme over months to years. The failure to heal these ulcers can be related to the underlying disease process, sometimes lack of patient compliance, and possibly, less than optimal treatment. Even when the exact diagnosis is made and appropriate treatment instituted, many ulcers may, nonetheless, require months of intervention. Certainly, the nonresponsive ulcer is best managed by an appropriate wound biopsy and culture, including a colony count.