A. History
Duration- For how long is the ulcer present.
Mode of onset- Following trauma or spontaneously or following a swelling.
Site- Where first noticed.
Progress of the ulcer-
Any pain over the ulcer
Any discharge- Serous/Purulent/Haemorrhagic
Any associated disease- Diabetes/ Sickle cell anaemia/ pulmonary tuberculosis/ Varicose vein/ Systemic malignancy/ AIDS.
6. Examination of chest in case of tuberculous ulcer.
B. Physical Examination
I. General Survey
II. Local examination of ulcer
1. Inspection:
Number
Site
Extent
Shape
Size
Margin
Undermined
Punched Out
Sloping
Raised or Rolled out
Everted
Floor of ulcer
Discharge- character, amount, smell
Adjacent area-
Any swelling
Any skin change
Any secondary changes
Any associated venous diseases
2. Palpation:
Temperature
Tenderness
Margin of ulcer- type, any induration
Base- The area on which ulcer rests. (Feel the base by picking up the ulcer in between the thumb, index and middle fingers)
Test mobility of ulcer over the deeper structure.
Any discharge during palpation- Bleeding or mucous discharge.
3. Examination of regional lymph nodes.
4. Examination of vascular disease.
5. Examination of any nerve lesion.