Chronic Wound: Or something else? Differential Diagnosis

Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99).

  • Factor V mutation – genetic blood clotting disorder leading to an increased tendency to thrombosis.
  • Klinefelter syndrome – gonosome (sex chromosome) abnormality of the male sex leading to primary hypogonadism (gonadal hypofunction).
  • Spina bifida – embryonic closure disorder in the area of the spine (malformation of the neural tube; neural tube defect) to cranial or caudal (“located up or down”) of varying degrees.

Blood, hematopoietic organs – immune system (D50-D90).

  • Werlhof disease (idiopathic thrombocytopenic purpura, ITP) – autoantibody-mediated disorder of platelets (thrombocytes) with spontaneous small-spotted bleeding.
  • Polycythaemia vera – abnormal proliferation of blood cells (particularly affected are: especially erythrocytes/red blood cells, to a lesser extent also platelets (blood platelets) and leukocytes/white blood cells); prickly itching after contact with water (aquagenic pruritus).
  • Sickle cell anemia (med.: drepanocytosis; also sickle cell anemia, sickle cell anemia) – genetic disease with autosomal recessive inheritance affecting erythrocytes (red blood cells); it belongs to the group of hemoglobinopathies (disorders of hemoglobin; formation of an irregular hemoglobin called sickle cell hemoglobin, HbS).
  • Sideroachrestic anemia – special form of aplastic anemia (anemia).
  • Spherocytosis (spherocytosis).
  • Thalassemia – autosomal recessive hereditary synthesis disorder of the alpha or beta chains of the protein portion (globin) in hemoglobin (hemoglobinopathy/diseases resulting from impaired formation of hemoglobin).
    • Α-Thalassemia (HbH disease, hydrops fetalis/generalized fluid accumulation); incidence: mostly in Southeast Asians.
    • Β-Thalassemia: most common monogenetic disorder worldwide; incidence: People from Mediterranean countries, Middle East, Afghanistan, India and Southeast Asia.
  • Thrombocythemia – strong multiplication of blood platelets.

Endocrine, nutritional and metabolic diseases (E00-E90).

  • Amyloidosis Amyloidosis – extracellular (“outside the cell”) deposits of amyloids (degradation-resistant proteins) that can lead to cardiomyopathy (heart muscle disease), neuropathy (peripheral nervous system disease), and hepatomegaly (enlargement of the liver), among other conditions
  • Calciphylaxis (synonym: uremic calcifying arteriolopathy, UCA; metastatic calcification) – severe and painful progression of bone loss due to renal disease (renal osteodystrophy).
  • Diabetes mellitus (diabetes) with wound healing disorders: eg, diabetic foot or diabetic foot syndrome.
  • Dysproteinemia – disorder of the protein balance in the blood, in which there is a quantitative disproportion between the plasma proteins.
  • Malnutrition (deficiency of: Protein (albumin), vitamin C, folate, iron, selenium, zinc).

Skin and subcutaneous (L00-L99).

  • Decubital ulcers (pressure ulcers) in immobilization/decubitus.
  • Necrobiosis lipoidica – inflammation of the middle dermis with accumulation of lipids leading to necrosis (tissue death) (1% of diabetics; about 60% of patients with such a skin disease have diabetes mellitus)
  • Pyoderma gangraenosum – painful disease of the skin in which there is ulceration or ulceration (ulceration or ulcer) and gangrene (tissue death due to reduced blood flow or other damage) over a large area, usually in one spot
  • Ulcus cruris venosum – lower leg ulcer, which is caused by venous insufficiency (2/3 of cases).

Cardiovascular system (I00-I99)

  • Angiodysplasia (vascular malformations).
  • Lymphatic drainage disorders
  • Peripheral arterial occlusive disease (pAVK) – progressive stenosis (narrowing) or occlusion (closure) of the arteries supplying the arms / (more often) legs, usually due to atherosclerosis (arteriosclerosis, arteriosclerosis).
  • Ulcus cruris arteriosum – lower leg ulcer, which is due to arterial occlusive disease.
  • Ulcus cruris hypertonicum – ulcer of the lower leg, which is caused by inferior supply of the tissue with blood due to angiolitis (vascular inflammation).
  • Ulcus cruris mixtum – lower leg ulcer, which is caused by a combination of arterial and venous circulatory disturbance.
  • Ulcus cruris varicosum – lower leg ulcer, which is caused by varicose veins.
  • Vasculitides (vascular inflammation) such as in the context of periarteriitis nodosa or pyoderma gangraenosum (painful disease of the skin, in which it comes over a large area, usually in one place, to an ulceration or ulcer (ulceration or ulcer) and gangrene (tissue death due to a reduction in blood flow or other damage).
  • Vasculopathy as in cholesterol emboli, calciphylaxis, necrobiosis lipoidica.

Infectious and parasitic diseases (A00-B99).

  • Skin infections, unspecified (e.g., mycobacteriosis, sporotrichiosis).

Musculoskeletal system (M00-M99).

Neoplasms – tumor diseases (C00-D48).

Psyche – nervous system (F00-F99; G00-G99).

  • Alcohol abuse (alcohol dependence)
  • Neuropathies – collective term for diseases of the peripheral nervous system.

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).

  • Gangrene – local tissue death; distinguish dry and wet gangrene.

Injuries, poisonings and certain other consequences of external causes (S00-T98).

  • Tampering
  • Injuries

Medication

Operations

  • Wound healing complications after surgery – Patients with depression or anxiety disorders are more likely to experience wound complications after surgery

Environmental exposure – intoxications (poisonings).

  • Chemical or physical damage, unspecified.