Artefactual ulcers

Some patients cause ulcers by pulling skin off their feet (Fig. 4.39) or applying noxious substances, or prevent ulcers from healing.

The patients we have seen have been young and mostly female, and have suffered in the past from eating disorders or 'brittle' diabetes.

Fig. 4.38 (a) This patient developed necrosis on the front of the ankle from a bandage which became too tight when her oedema increased, (b) A close-up view of the iatrogenic lesion shown in (a). The conventional bandage was replaced with light tubular bandage which could accommodate her oedema.
Fig. 4.39 This girl with peripheral neuropathy scratched the skin off her ankle and kept the wound open for 7 weeks.

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