Current Dermatology Reports

, Volume 7, Issue 3, pp 180–189 | Cite as

Leg Ulcers: Expanding the Differential

  • Jesse J. KellerEmail author
Hospital- based Dermatology (D Kroshinsky, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Hospital-based Dermatology


Purpose of Review

Cutaneous lower extremity ulcerations are major source of morbidity and mortality. It can be challenging to identify an underlying etiology. This review provides a systematic framework for generating a thoughtful differential diagnosis and workup approach. We also highlight recent discoveries in the pathophysiology and treatment approaches of leg ulceration.

Recent Findings

Venous leg ulceration is being treated with a number of promising new modalities including pentoxifylline, statin therapy, topical timolol, connexin-43 peptide antagonists, photodynamic therapy, and punch grafting. The role of vitamin K deficiency is gaining prominence with regard to calciphylaxis.


Recognition of key risk factors and subtle physical exam findings can serve as clues to the underlying mechanism of cutaneous ulceration and direct a targeted workup for underlying systemic disease that may be ameliorated with appropriate therapy.


Leg ulcer Venous ulcer Calciphylaxis Pyoderma gangrenosum Livedoid vasculopathy 


Compliance with Ethical Standards

Conflict of Interest

Dr. Keller has no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major Importance

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Authors and Affiliations

  1. 1.Department of DermatologyOregon Health and Science UniversityPortlandUSA

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