history

Last reviewed 01/2018

A comprehensive history is vital in making a diagnosis of any leg ulcer. These should include:

  • general health status
  • past and current medical history of relevant diseases e.g. - deep vein thrombosis, diabetes, autoimmune disorders, inflammatory bowel disease, and connective tissue disease
  • history and status of the ulcer 
    • rapidity of onset
    • preceding events, e.g. trauma or surgery at the site of the ulcer
    • duration of ulceration; gives an indication of chronicity and likelihood of successful treatment
    • previous treatment
    • whether it is a first episode or recurrent
    • symptoms:
      • venous disease:
        • pain
        • 'heaviness'
        • aching
        • itching
        • swelling
        • pigmentation
        • eczema
      • arterial:
        • intermittent claudication
        • pain, which persists at rest
    • relevant predisposing factors
      • venous disease:
        • varicose veins
        • deep vein thrombosis in past
        • phlebitis
        • previous fractures, trauma or surgery
      • arterial disease:
        • ischaemic heart disease
        • transient ischaemic attacks of cerebrovascular events
        • peripheral vascular disease
        • cigarette smoking
        • hypertension
        • hypercholesterolaemia
        • diabetes mellitus
        • rheumatoid arthritis
  • family history e.g. venous disease, diabetes mellitus
  • recent foreign travel; may be suggestive of rare infective aetiologies
  • ambulatory status of patient
  • type of footwear worn
  • patient psychological status; likely compliance with treatment
  • nutrition (1,2,3)

Quality of life in patients with leg ulcers has shown to be poor when compared with age matched controls.

  • pain was the major complaint with males experiencing greater pain intensity than females
  • in addition restricted mobility, sleep disturbances etc are responsible for poor quality of life (2,3)

Reference: