Examination of ulcer history taking

1. EXAMINATION OF ULCER
-HISTORY
-BY
ABHIRAM YASHASWI
ROLL NO:-02

2. WHAT IS AN ULCER?
• An ulcer is a discontinuity of an epithelial surface
• Characterized by progressive destruction of the surface epithelium
and a granulating base

4. CLASSIFICATION OF ULCERS
• Ulcers are classified into:-non specific ,specific ,malignant
• A) non-specific:-peptic ulcers ,pressure sores ,gravitational
ulcers(venous insufficiency) ,traumatic ulcers ,aphthous ulcers
• B)specific (infective type):-herpes simplex ,tuberculous ,syphilis
• c)malignant:-gastric carcinoma

5. MODE OF ONSET
• How has the ulcer developed following a trauma or
spontaneously?
• TRAUMATIC ULCERS:-Generally heal by themselves if the
traumatic agent is removed
• Ulcer enlarges if the traumatic agent persists ,e.g.-dental ulcer of
tongue
• Healing of an ulcer is delayed if it lies over a joint

6. • SPONTANEOUS ULCER:-follows a swelling ,which may be matted
tuberculous lymph nodes or gumma or rapidly growing malignant
tumor
• Ulcers may be present in the leg with varicose veins or vascular
insufficiency

7. DURATION
• How long is the ulcer present there?
• Acute ulcer is present for a short duration
• Chronic ulcer will remain for a long duration
• Incubation period-time interval between exposure and onset of
ulcer

8. PAIN
• Is the ulcer painful?
• Only the ulcers associated with inflammation will be painful
• Syphilitic and tropic ulcers resulting from nerve diseases are
painless
• Tuberculous ulcers are slightly painful
• Ulcers from malignant diseases such as epithelioma or basal cell
carcinoma are absolutely painless to start with and never become
painful unless they infiltrate structures supplied by pain nerve
endings

9. DISCHARGE
• Does the ulcer discharge or not?
• If it discharges enquiry must be made about its nature- serum
,pus, or blood

10. ASSOCIATED DISEASES
• If present-nervous diseases such as tabes dorsalis ,syringomylia
may result in an ulcer
• Syphilis at the primary stage gives rise to chancre and in tertiary
stage gives rise to gummatous ulcer

11. THANK YOU