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.