Caudill J, Chrisman T, Chen J, Zajac K, Simman R, et al.
Journal of wound care. Date of publication 2023 Sep 1;volume 32(Sup9):S22-S36.
1. J Wound Care. 2023 Sep 1;32(Sup9):S22-S36. doi:
10.12968/jowc.2023.32.Sup9.S22.
Differential diagnosis of stage 2, 3 and 4 pressure injuries of the pelvis and
lower extremity: a case series.
Caudill J(1), Chrisman T(1), Chen J(1), Zajac K(1), Simman R(1)(2).
Author information:
(1)University of Toledo, College of Medicine and Life Science, Department of
Surgery, Toledo, Ohio, US.
(2)Jobst Vascular Institute, ProMedica Health Network, Toledo, Ohio, US.
Constant, unrelieved pressure of local tissue, particularly over bony
prominences, may provoke damage that progresses to necrosis and pressure injury
(PI). Differentiating PIs from conditions of similar appearance is imperative to
minimising complications and implementing prompt treatment. This case series
describes several conditions that may be mistaken for a PI. Outlined are the key
differences in patient history, presentation and clinical cues that assist in
correctly identifying the true pathology behind these conditions. Conditions
reviewed included: pyoderma gangrenosum; necrotising fasciitis; genital herpes;
Marjolin ulcer, Rosai-Dorfman disease; vascular disease; coagulopathies;
calciphylaxis; trauma and surgical wounds; pilonidal cysts; graft-versus-host
disease; hidradenitis suppurativa; Stevens-Johnson syndrome; epidermolysis
bullosa; radiation wounds; spider bites; and end-of-life skin failure pressure
ulcers (also known as Kennedy ulcers). Although commonly recognised and
diagnosed, stage 2, 3 and 4 PIs occasionally prove to be difficult to pinpoint,
with undefined characteristics and similarities in presentation to several other
conditions. Therefore, it is clinically vital to be aware of their appearance,
risk factors and aetiology in order to make an appropriate patient assessment
and avoid misdiagnosis.
DOI: 10.12968/jowc.2023.32.Sup9.S22
PMID: 37682800 [Indexed for MEDLINE]
Conflict of interest statement: Declaration of interest: The authors have no
conflicts of interest to declare.
