Malum perforans

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Malum perforans
Synonyms	Perforating ulcer
Pronounce	N/A
Specialty	Podiatry, Endocrinology
Symptoms	Ulcers on the foot, often on pressure points
Complications	Infection, osteomyelitis, amputation
Onset	Gradual
Duration	Chronic
Types	N/A
Causes	Diabetes mellitus, neuropathy
Risks	Poor glycemic control, peripheral neuropathy, peripheral artery disease
Diagnosis	Clinical examination, X-ray, MRI
Differential diagnosis	Venous ulcer, arterial ulcer, pressure ulcer
Prevention	N/A
Treatment	Offloading pressure, debridement, antibiotics, glycemic control
Medication	N/A
Prognosis	Variable, depends on glycemic control and infection management
Frequency	Common in patients with diabetes
Deaths	N/A

Malum_perforans

Malum perforans (also known as a trophic ulcer, or neurotrophic ulcer) is a long-lasting, usually painless ulcer that penetrates deep into or through the skin, usually on the bottom of the foot, associated with neurological and metabolic disorders, including diabetes mellitus, tabes dorsalis, and leprosy.

Symptoms

The main symptom of malum perforans is the presence of skin ulcers, usually on the bottom of the foot. These ulcers are typically painless and can penetrate deep into or through the skin.

Causes

Malum perforans is associated with several neurological and metabolic disorders. These include:

• Diabetes: High blood sugar levels can damage nerves over time, leading to neuropathy and the development of malum perforans.
• Tabes dorsalis: This is a form of neurosyphilis, which can cause nerve damage and lead to the development of malum perforans.
• Leprosy: This infectious disease can cause nerve damage and skin ulcers, leading to malum perforans.

Treatment

Treatment for malum perforans focuses on managing the underlying condition causing the ulcers. This may involve:

• Blood sugar control for diabetes
• Antibiotics for tabes dorsalis or leprosy
• Wound care for the ulcers, including cleaning and dressing the wound, and off-loading pressure from the ulcerated area.

See also

• List of cutaneous conditions
• Neuropathy
• Diabetes mellitus
• Tabes dorsalis
• Leprosy

References

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