Clinical-Epidemiological Study of Patients with Atypical Wounds: A Retrospective Analysis

Background: The majority of chronic wounds are caused by venous or arterial insufficiency, prolonged pressure or diabetes. Atypical wounds are secondary to others causes like infection, metabolic disorders, cancers, inflammatory processes or external factors. Atypical ulcers are hard to manage with conventional treatments so a specific clinical, histological diagnosis and appropriate therapy are required.

Purpose: The aim of the present retrospective study was to analyze clinical features, systemic associations and therapeutic approaches of 165 patients with atypical wounds.

Methods: 165 patients with atypical wounds, aged from 7 to 90 years were evaluated during a 7-years period (2010-2017). Clinical and histological features, associated comorbidities, systemic and local therapies were documented. Biopsies were performed for histopathological and microbiological evaluation. A digital camera and a 3D imaging system (Star Aranz) were used to provide the precise measurement of wounds size and healing trends evolution.

Results: The data included different types of atypical ulcers like malignancy, external causes, inflammatory conditions, metabolic disorders, bullous diseases, infections, and connective tissue disease. Inflammatory ulcer was the most prevalent category (n=90), followed by ulcerated malignancy (n=43), such as cutaneous carcinomas and melanomas. Different systemic, local and surgical treatments were used based on the clinical and histological types.

Conclusion: The primary endpoint was to collect data of atypical ulcers in order to characterize the features of the different lesions and to detect the correct management and the prognostic value in each case.