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History

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

A comprehensive history is vital in making a diagnosis of any leg ulcer. These should include:

  • general health status
  • past and current medical history of relevant diseases e.g. - deep vein thrombosis, diabetes, autoimmune disorders, inflammatory bowel disease, and connective tissue disease
  • history and status of the ulcer
    • rapidity of onset
    • preceding events, e.g. trauma or surgery at the site of the ulcer
    • duration of ulceration; gives an indication of chronicity and likelihood of successful treatment
    • previous treatment
    • whether it is a first episode or recurrent
    • symptoms:
      • venous disease:
        • pain
        • 'heaviness'
        • aching
        • itching
        • swelling
        • pigmentation
        • eczema
      • arterial:
        • intermittent claudication
        • pain, which persists at rest
  • relevant predisposing factors
    • venous disease:
    • varicose veins
    • deep vein thrombosis in past
    • phlebitis
    • previous fractures, trauma or surgery
    • arterial disease:
      • ischaemic heart disease
      • transient ischaemic attacks of cerebrovascular events
      • peripheral vascular disease
      • cigarette smoking
      • hypertension
      • hypercholesterolaemia
      • diabetes mellitus
      • rheumatoid arthritis
  • family history e.g. venous disease, diabetes mellitus
  • recent foreign travel; may be suggestive of rare infective aetiologies
  • ambulatory status of patient
  • type of footwear worn
  • patient psychological status; likely compliance with treatment
  • nutrition (1,2,3)

Quality of life in patients with leg ulcers has shown to be poor when compared with age matched controls.

  • pain was the major complaint with males experiencing greater pain intensity than females
  • in addition restricted mobility, sleep disturbances etc are responsible for poor quality of life (2,3)

Reference:

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