Ulcers can occur in the gaiter area of the leg in people with longstanding varicose veins, or with a previous history of deep venous thrombosis. They often start after relatively minor trauma to an area of skin which is dry and pigmented or which has previously been subject to repeated inflammation or infection.
Once the skin has broken, the ulcer usually increases in size fairly rapidly and it may take many weeks or months for it to regress. There is often a surrounding area of eczema and the ulcer may weep copiously. Secondary infections may complicate treatment.
Although venous disease is a common cause of leg ulceration in the UK, there are many other predisposing conditions, such as arterial disease, rheumatoid arthritis and various inflammatory vascular conditions. Some of these conditions are easier to treat than others.
Management and cure of venous ulcers is time-consuming: success depends partly on correct diagnosis and treatment of the underlying cause, associated with meticulous attention to detail in the everyday care of the leg. Once healed, the underlying cause should also be treated to prevent recurrence.