(Ulcers; Ulcera)
Definition. Ulcerations are variously shaped and sized losses of cutaneous substance, often extending into the subcutaneous layer, and resulting from disease.
Ulcers may be small or without definite limit; they may be round, irregular or serpiginous; their edges may be sharp, rounded, everted or undermined; they may be superficial or deep; their bases may be smooth, irregular or sloughy, covered with pus or serum or be comparatively clean. The discharge may be very offensive or without odor. If not interfered with, they usually crust over as the result of their dried product. They vary greatly in their course and duration; but unless malignant in nature, tend to heal spontaneously and invariably by cicatrization. Ulcers may or may not be painful, sensitive or bleed easily. A large number of ulcerations are due to syphilis, commonly to the tubercular and gummatous varieties. In these instances the process is due to cell-growth combined with suppuration and necrosis. However, they may be traced to impaired nutrition of the part as in varicose ulcers on the lower parts of the legs; to suppurative ulcerations as in ecthyma and furunculus; or to infiltration as in neoplastic formations such as tuberculosis cutis, leprosy, sarcoma and carcinoma. While ulcers may occur upon any part of the body, they are commonly seen upon the legs. However, those of lupus and syphilis are frequently noted upon the face, and those of dermatitis gangrenosa are apt to be generalized.