Ulcer: Examination

                                      Ulcer: Examination

[A] Inspection

1.       „Number

2.       „Site: In relation to the region or bony landmark

3.       „Extent

4.       „Shape/Size

5.       „Margin

·         Junction of normal skin and the periphery of the edge of the ulcer

6.       Edge of the ulcer

·         Area of the ulcer between the floor and the margin

§     Sloping- Healing Ulcer

§     Undermined -TB

§     Punched out – Gummatous or deep trophic ulcer

§     Raised and pearly white beaded Edge- Rodent ulcer

§     Rolled out (Everted) Edge- SCC

7.       Floor of ulcer

·         Exposed portion of the ulcer

·         Covered by red granulation tissue/pale granulation tissue/slough

8.       Discharge

·         character, amount, smell

9.       Adjacent area

·         Any swelling

·         Any skin change

·         Any secondary changes, pigmentation, pallor

·         Any associated venous diseases

[B] Palpation

1.       Temperature/ tenderness„

2.       Size of the ulcer

3.       Margin and edge of ulcer

4.       Base: The area on which ulcer rests

·         Feel the base by picking up the ulcer in between the thumb, index and middle finger

·         Marked induration in Scc and Hunterial ulcer

5.       Mobility of ulcer over the deeper structure/ Relationship with deeper structures

6.       Bleeding to touch or not

7.       Surrounding  Skin