32 Introduction to ulcerative and erosive dermatoses EROSIONS AND ULCERS An erosion is a lesion involving loss of some or all of the layers of the epidermis, but without disruption of the basement membrane (Fig. 32.1). As a rule, these lesions do not bleed easily. Figure 32.1 Diagrammatic representation of an erosion. The basement membrane remains intact. An ulcer is a lesion involving complete loss of the epidermis and also involving disruption of the basement membrane, leading to exposure of the underlying dermis (Fig. 32.2). Ulcers do tend to bleed easily. Ulcerated lesions also tend to crust due to the accumulation of blood and/or exudate on the skin surface. Clinically, it can sometimes be difficult to differentiate between deeper erosions and shallow ulcers. Features that may be helpful in determining the cause of ulcers and that should be considered when describing them include the site of the ulcer, the appearance of the border and base, any discharge and the nature of the surrounding skin. Figure 32.2 Diagrammatic representation of an ulcer. The basement membrane has been breached. Ulceration results in loss of the protection afforded by the epidermis, with leakage of fluids and electrolytes, and exposure of the underlying dermis to bacterial colonization, infection and potentially life-threatening sepsis. A more aggressive diagnostic approach is warranted in cases where there is significant ulceration. AETIOLOGY Extrinsic trauma and intrinsic disorders can both result in cutaneous erosions and ulcers. Extrinsic trauma The most common cause of erosive and ulcerative skin disease is from self-trauma due to an underlying pruritic skin disorder (Fig. 32.3). The distribution and appearance of the lesions in these cases will reflect the nature of the insult. Lesions in cases of self-trauma frequently have a linear distribution. Other external insults such as chemical or thermal burns will have varying morphologies depending on the agent involved. Figure 32.3 Crusted erosions and ulcers in a cat due to self-trauma as a result of pruritus. Only gold members can continue reading. Log In or Register to continue You may also needUveodermatological syndromeDermatophytosis in a guinea-pigIntroduction to crusting and scalingCutaneous lupus erythematosusVasculitisCornea – introductionEosinophilic folliculitis and furunculosisConjunctiva – introduction Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)Click to share on Google+ (Opens in new window) Related Tags: Saunders Solutions in Veterinary Practice Small Animal Dermatolo Sep 3, 2016 | Posted by admin in SMALL ANIMAL | Comments Off on Introduction to ulcerative and erosive dermatoses Full access? Get Clinical Tree
32 Introduction to ulcerative and erosive dermatoses EROSIONS AND ULCERS An erosion is a lesion involving loss of some or all of the layers of the epidermis, but without disruption of the basement membrane (Fig. 32.1). As a rule, these lesions do not bleed easily. Figure 32.1 Diagrammatic representation of an erosion. The basement membrane remains intact. An ulcer is a lesion involving complete loss of the epidermis and also involving disruption of the basement membrane, leading to exposure of the underlying dermis (Fig. 32.2). Ulcers do tend to bleed easily. Ulcerated lesions also tend to crust due to the accumulation of blood and/or exudate on the skin surface. Clinically, it can sometimes be difficult to differentiate between deeper erosions and shallow ulcers. Features that may be helpful in determining the cause of ulcers and that should be considered when describing them include the site of the ulcer, the appearance of the border and base, any discharge and the nature of the surrounding skin. Figure 32.2 Diagrammatic representation of an ulcer. The basement membrane has been breached. Ulceration results in loss of the protection afforded by the epidermis, with leakage of fluids and electrolytes, and exposure of the underlying dermis to bacterial colonization, infection and potentially life-threatening sepsis. A more aggressive diagnostic approach is warranted in cases where there is significant ulceration. AETIOLOGY Extrinsic trauma and intrinsic disorders can both result in cutaneous erosions and ulcers. Extrinsic trauma The most common cause of erosive and ulcerative skin disease is from self-trauma due to an underlying pruritic skin disorder (Fig. 32.3). The distribution and appearance of the lesions in these cases will reflect the nature of the insult. Lesions in cases of self-trauma frequently have a linear distribution. Other external insults such as chemical or thermal burns will have varying morphologies depending on the agent involved. Figure 32.3 Crusted erosions and ulcers in a cat due to self-trauma as a result of pruritus. Only gold members can continue reading. Log In or Register to continue You may also needUveodermatological syndromeDermatophytosis in a guinea-pigIntroduction to crusting and scalingCutaneous lupus erythematosusVasculitisCornea – introductionEosinophilic folliculitis and furunculosisConjunctiva – introduction Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)Click to share on Google+ (Opens in new window) Related Tags: Saunders Solutions in Veterinary Practice Small Animal Dermatolo Sep 3, 2016 | Posted by admin in SMALL ANIMAL | Comments Off on Introduction to ulcerative and erosive dermatoses Full access? Get Clinical Tree
