[The pathogenesis of trophic ulcers of the lower extremities]

The notion of a trophic ulcer is nosologically indefinite at present. Basing on current understanding of the pathogenesis of the processes that underlie the development of trophic ulcers on the lower limbs, the authors present a classification of such ulcers. They suggest a working scheme of trophic ulcers pathogenesis; according to this scheme, impaired blood microcirculation [correction of microhemocirculation] in the skin underlies the development of trophic ulcers on the lower limbs. These disorders involve hemocoagulation, angiopathic, and chronic inflammatory processes in the derma, that lead to necrosis and sclerosis of dermal connective tissue. Contribution of the body reactivity characteristics to the formation of trophic ulcers is discussed, as are the role of skin morphofunctional features and of exogenous factors. The authors believe that closely related pathogenetic mechanisms of trophic ulcer development imply treatment with the same complex of therapeutic modalities.