Atypical Ulcers: Diagnosis and Management

Agata Janowska,1 Valentina Dini,1 Teresa Oranges,1,2 Michela Iannone,1 Barbara Loggini,3 Marco Romanelli1 1Department of Dermatology, University of Pisa, Pisa, Italy; 2Department of Health Sciences, Anna Meyer Children University Hospital, University of Florence, Florence, Italy; 3Department of Pathology, University of Pisa, Pisa, ItalyCorrespondence: Agata JanowskaDepartment of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, ItalyTel +39 050 992436Fax +39 050 992556Email dottoressajanowska@gmail.comAbstract: Atypical ulcers show atypical clinical features, histology, localization, and resistance to standard therapies. The persistence of a chronic ulcer despite treatment with standard therapies requires a more specific diagnostic investigation. Diagnosis involves obtaining the history and performing clinical examination and additional tests. A skin biopsy is frequently used to confirm unclear diagnosis. In difficult cases, microbiological and immunohistochemical examinations, laboratory blood tests, or instrumental tests should be evaluated. The treatment of atypical wounds is characterized by local systemic therapy and pain control. Our results highlight the need for early diagnosis, and standardized and targeted management by a multidisciplinary wound healing center.Keywords: atypical ulcers, wound healing, wound bed preparation, wound management