Management of unusual causes of ulcers of lower extremities

Treatment of any wound begins with the correct diagnosis. The vast majority of chronic wounds can be classified as pressure ulcers, venous ulcers, insensate ulcers, or arterial insufficiency ulcers. This article focuses on wounds of unusual origin that must be considered in evaluation. All of these wounds are difficult to treat, are more likely to occur in specialized clinical settings, may provide clues to underlying systemic illnesses, and can be life-threatening. Unusual wounds discussed include atrophe blanche, calciphylaxis, leukocytoclastic vasculitis, necrobosis lipoidica, necrotizing fasciitis, and pyoderma gangrenosum.