ORIGINAL ARTICLES   

Acta Vulnologica 2010 June;8(2):81-6

Copyright © 2010 EDIZIONI MINERVA MEDICA

language: Italian

Criticalities in the recognition of vasculitic skin ulcers (ECRUV): preliminary results from the ECRUV study

Manzo C., Nebbioso G., Bollini M. G., Bonati P. A., Chirico M., Gelmini G., Marino S., Pavese I., Petrella F., Putignano S.

Azienda Sanitaria Locale Napoli 1, Napoli, Italia

In the vast spectrum of chronic skin lesions of the lower extremities, vasculitic ulcers make up a small part yet pose a diagnostic and therapeutic challenge. Their common feature is an inflammatory process, even if induced, of one or more vessel wall components. Skin ulcers are one possible clinical manifestation of vasculitis. The lesion may be preceded or accompanied by other clinical manifestations; often it signals the onset of disease and its recognition is challenging. The aim of this study was to identify by means of a questionnaire those elements which generally delay or impede the diagnosis of vasculitic ulcers. Several interesting observations can be derived from the questionnaire responses. Particularly noteworthy is a substantial heterogeneity in the approach to the recognition of a possible vasculitic genesis of the ulcer as regards the identification of elements that may arouse greater diagnostic suspicion and as regards the weight to be attributed to changes in the surrounding skin: just over one third of specialists (35.4%) cited atypical ulcer location as a major element of suspicion of an ulcer’s potential vasculitic nature; others stated that in their approach they rely on other manifestations (persistence of pain also at night, color intensity, sharpness of borders, pitting) which are objectively less specific and more relevant for diagnosing other types of ulcers (e.g., arteriopathic ulcers).