ulcerAn open sore appearing on the
skin or on a mucous membranethat
results from the destruction of surface
tissue. Ulcers may be shallow, or deep
and crater-shaped, and they are usually
inflamed and painful.
Skin ulcers most commonly occur on
the leg (see leg ulcer), usually as the
result of inadequate blood supply to, or
drainage from, the limb. In some cases
skin cancers, particularly basal cell car-
cinomasor squamous cell carcinomas,
may be ulcerated. Rarely, a cancer may
develop in the skin at the edge of a
longstanding ulcer.
The most common types of ulcers of
the mucous membranes are mouth ul-
cers, peptic ulcers, and those that occur
in ulcerative colitis.
Ulcers may also affect the skin or
mucous membranes of the genitalia
(see genital ulcer). Most genital ulcers are
caused by sexually transmitted infec-
tions. Examples of this type of ulcer are
hard chancres (see chancre, hard), which
develop during the first stage of syph-
ilis, and soft chancres (see chancroid).
In addition, ulcers may develop on the
cornea (seecorneal ulcers).
ulcer, aphthousA small, painful ulcer
that occurs, alone or in a group, on the
inside of the cheek or lip or underneath
the tongue. Aphthous ulcers are most
common between the ages of 10 and 40
and affect more women than men. The
most severely affected people have con-
tinuously recurring ulcers; others have
just 1 or 2 ulcers each year.
Each ulcer is usually small and oval,
with a grey centre and a surrounding
red, inflamed halo. The ulcer, which
usually lasts for 1–2 weeks, may be a
hypersensitive reaction to haemolytic
streptococcus bacteria. Other factors
commonly associated with the occur-
rence of these ulcers are minor injuries(such as at an injection site or from a
toothbrush), acute stress, or allergies
(such as allergic rhinitis). In women,
aphthous ulcers are most common dur-
ing the premenstrual period. They may
also be more likely if other family mem-
bers suffer from recurrent ulceration.
Analgesic mouth gels or mouthwashes
may ease the pain of an aphthous ulcer.
Some ointments form a waterproof cov-
ering that protects the ulcer while it is
healing. Ulcers heal by themselves, but
a doctor may prescribe a paste contain-
ing a corticosteroid drugor a mouthwash
containing an antibiotic drugto speed
up the healing process.
ulcerationThe formation or presence
of 1 or more ulcers.
ulcerative colitisChronic inflammation
and ulceration of the lining of the colon
and rectum, or, especially at the start of
the condition, of the rectum alone. The
cause of ulcerative colitis is unknown,
but the condition is most common in
young and middle-aged adults.
The main symptom of ulcerative coli-
tis is bloody diarrhoea; and the faeces
may also contain mucus. In severe
cases, the diarrhoea and bleeding are
extensive, and there may be abdominal
pain and tenderness, fever, and general
malaise. The incidence of attacks varies
considerably. Most commonly, the at-
tacks occur at intervals of a few months.
However, in some cases, there may be
only a single episode.
Ulcerative colitis may lead to anaemia,
caused by blood loss. Other complica-
tions include a toxic form of megacolon,
which may become life-threatening;
rashes; aphthous ulcers; arthritis; con-
junctivitis;or uveitis. There is also an
increased risk of cancer of the colon
developing (see colon, cancer of).
A diagnosis is based on examination
of the rectum and lower colon (see
sigmoidoscopy) or the entire colon (see
colonoscopy), or is made by a barium
enema (see barium X-ray examination).
During sigmoidoscopy or colonoscopy,
a biopsymay be performed. Samples of
faeces may be taken for laboratory anal-
ysis in order to exclude the possibility
of infection by bacteria or parasites.
Blood testsmay also be needed.ULCER ULCERATIVE COLITISU