Leg ulcers: A common problem with sometimes uncommon etiologies

In the U.S., leg ulcers present a significant clinical problem, occurring a t a rate of approximately 600, 000 new cases per year. In most cases, the c ause of ulceration is venous or arterial in nature. One uncommon but signif icant cause of leg ulcers is sqaumous cell carcinoma (SCC). Although the in cidence of SCC is higher in white than black populations, blacks with SCC t ypically exhibit involvement of areas of the shin. that are not chronically sun-exposed, especially the lower extremeties. Predisposing factors includ e burn scars, chronic infection or ulceration, and chronic discoid lupus er ythematosus. Leg ulcers of atypical presentation or those that fail to heal should alert the clinician to consider uncommon etiologies.