1 Introduction:
The three primary types of ulcers that affect the lower extremities are venous ulcers, arterial ulcers, and neuropathic ulcers [1,2]. Venous ulcers are the most common type of leg ulcers, while foot ulcers are more likely to be caused by arterial insufficiency or neuropathy [2]. Approximately 80% of leg ulcers are caused by venous disease, while arterial disease accounts for around 10% to 25% and can also coexist with venous disease [2]. As our population ages, the incidence of arterial insufficiency may increase. Additionally, about 10% to 15% of patients with leg ulcers have coexisting rheumatologic disease, and 5% to 12% have diabetes mellitus [2 - 5]. Less commonly, trauma, pressure, or infectious agents such as buruli ulcer, cutenous leshmanaisis and ulcerated mycetoma lesion can also cause leg ulcers [2 - 7]. It’s important to note that these causes can overlap with each other and coexist with other medical conditions because they are not mutually exclusive [8].
The course and prognosis of leg ulcers can differ based on their underlying causes [2]. Compared to ulcers caused by arterial insufficiency, venous ulcers are generally less painful and have a lower likelihood of leading to amputation [2]. However, they still tend to be chronic and can exhibit unpredictable behavior. The long-lasting nature of venous ulcers, along with the associated morbidity and financial burden, has sparked renewed interest in developing innovative approaches to accelerate healing and improve outcomes [2]. Additionally, it is crucial to challenge the misconception that venous ulcers are not painful. Recent studies indicate that up to three-fourths of patients with venous ulcers experience pain, significantly impacting their overall quality of life. In this communication, we present a patient with venous ulcer that mimic cutenous leshmaniasis and mycetoma lesion.