Pathogenesis

The pathogenesis of leg uceration is often multifactorial, but there are often key underlying processes such as decreased skin perfusion and infection. Ischaemia can result from disease in any part of the circulatory tree. For example, microcirculatory flow may be diminished with atherosclerosis, diabetes or vasculitis. Similarly, venous hypertension can cause relative ischaemia of the capillary bed through lack of outflow. In ischaemic tissue, the ability of skin to combat infection is reduced and consequently subclinical infection can commence.