Perforating ulcer. Small ulcer on the sole of a patient's foot. This type of ulcer, known as mal perforant, occurs following disease or injury to the nerves supplying the skin of the foot. The ulcer that forms is chronic and painless as a result of sensory denervation. Perforating ulcers are often associated with diabetes. Treatment is by cleaning the ulcer if infected, regular dressing and application of zinc ointment. If the ulcer spreads, skin grafting may be necessary to replace damaged skin. Treatment of the underlying cause, for example diabetes, must also be implemented to prevent recurrence.
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