QUESTION: I have known many people with leg ulcers, and it seems always such a task to heal them and stop the oozing. Changing bandages gets old. I have known it to take two years to heal one. I am lucky to do it in three months. Please respond in your column. - J.K.
QUESTION: What causes leg ulcers? - R.J.ANSWER: Leg ulcers present two problems - the immediate ulcer and its cause. Let's treat the ulcer first, which is always the priority. J.K.'s right, it isn't the easiest job in the world.
First, you must absolutely must clean the area of dead tissue and bacteria that hang around such sites. If you don't clean, you won't heal. Inadequate cleaning accounts for the long healing times J.K. mentions. You should begin to get an upper hand on most leg ulcers in a couple of weeks.
Since I stress cleaning, let me list a couple of good cleaning agents. Wet dressings of Burow's solution or potassium permanganate are often used. Hexachlorophene soap will get rid of most dead tissue and bacteria. Some ulcers will require antibiotic ointments.
Now you wait and watch, recleaning and rebandaging, observing our results while moving to the second phase, control of the ulcer cause.
Just about 90 percent of ulcers result from defective veins leaking fluid into tissue. The resulting swelling impinges on arteries supplying the area. This lack of blood supply causes the ulceration. There are lots of other scenarios for skin ulcers, but I am sure this fits most cases. The goal is to restore proper circulation.
Restoring circulation not only helps the immediate healing, but prevents recurrence. Leg elevation is the key, and some actually require hospitalization to assure proper therapy and full restoration of leg circulation. Elastic bandages will help by compressing the defective veins, thus stopping much of the fluid from oozing out.
QUESTION: I am a regular reader. When I had my last physical, my doctor told me I had "erosion of the cervix." What is meant by this? Is it serious? Is it something to be concerned about? I am 38. - Mrs. B.F.
ANSWER: The cervix (for other readers) is the necklike opening of the uterus that extends toward the vaginal opening. Ninety percent of all women of childbearing age will be found to have some degree of cervical inflammation. An erosion is simply a patch of inflammation that has gotten out of hand. A sign of erosion might be a vaginal discharge or spotting between normal periods.
Erosions are noteworthy and require attention but seldom fall into the serious category. You can treat an erosion by cauterizing the tissue with an electric current. Or it can be frozen or removed with laser surgery. Once the focus of irritation is removed, the erosion is replaced by fresh healthy tissue.
QUESTION: My sister, in her 70s, has Schamberg's disease. Would you explain it, please. - E.C.S.
ANSWER: This is a skin disease, cause unknown. Small tan spots appear, usually on the lower legs. Around the periphery of each spot tiny red dots appear, making it appear as though it had been dusted with cayenne pepper.
Usually, Schamberg's is just left alone, but steroid creams can be used. The spots tend to fade away, but they can recur. You can't say how long they will remain each time.