Q&A: Commonly Misdiagnosed Ulcers and Atypical Ulcers

  • Jayesh B. Shah, MD, CWSP, UHM
  • Volume 07 - Issue 4

 Excerpt from Textbook of Chronic Wound Care

by Shah, Sheffield, and Fife. Coming in 2017

Textbook of Chronic Wound Care: An Evidence-Based Approach to Diagnosis and Treatment by Drs. Jayesh Shah, Paul Sheffield, and Caroline Fife, editors, is a companion reference book for the Wound Care Certification Study Guide, 2nd edition. Due for publication by Best Publishing Company in the first quarter of 2017, this textbook provides the best diagnostic and management information for chronic wound care in conjunction with evidence-based clinical pathways illustrated by case studies and more than 350 pictures. The textbook provides up-to- date information for the challenging chronic wound-care problems in an easy-to-understand format and includes the following features:

  • chapters written by more than 50 well-respected leaders in the specialty of wound care

  • balanced evidence-based multidisciplinary approach to chronic wound care

  • exclusive key concepts in every chapter for a quick review

  • excellent resource for preparation of wound care certification exams with 250 questions and answers

  • chapters specifically focus on understanding wound care in different settings

  • chapter on telehealth and wound care addressing the future of chronic wound care

  • deep understanding of value-based care in wound care in United States

  • separate section on approach to wound care in various countries globally

This book belongs in the library of every practitioner who treats chronic wound-care patients. It proves to be a valuable text for medical students and all health-care professionals

—including doctors, podiatrists, physician assistants, nurse practitioners, nurses, physical and occupational therapists

—in various settings. It provides through understanding of the evidence-based multidisciplinary approach for caring patients with different kinds of wounds.

The following question-and-answer excerpt is from Chapter 15, “Approach to Commonly Misdiagnosed Ulcers and Atypical Ulcers,” by Dr. Jayesh Shah.

1. All of the following are local factors contributing to nonhealing wound except

a. hypoxia

b. edema

c. microvascular disease

d. malnutrition

e. necrosis

2. Malignancy should be suspected with

a. history of repeated trauma

b. exuberant granulation tissue

c. rolled out edges

d. purple red color around the ulcer

e. wounds secondary to burns

f. all of the above

3. Match the following:

a. basal cell cancer

b. Marjolin's ulcer

c. Kaposi's sarcoma

d. pyoderma gangrenosum

e. calciphylaxis

  1. arises from keratinizing epidermal cells

  2. arises from epidermal basal cells

  3. associated with hyperparathyroidism

  4. malignant changes in edges of chronic wound

  5. associated with inflammatory bowel disease

  6. associated with AIDS

4. Match the following:

a. fish tank granuloma

b. Buruli ulcer

c. actinomycosis

d. Hansen's disease

e. sporotrichosis

  1. S.schenckii

  2. Gram +, nonspore-forming anaerobicbacteria

  3. Mycobacteria leprae

  4. Mycobacteria marinum

  5. Mycobacteria ulcerans


1. d


3a. 2

3b. 1 and 4

3c. 6

3d. 5

3e. 3

4a. 4

4b. 5

4c. 2

4d. 3

4e. 1

About the Author


JAYESH B. SHAH, MD, CWSP, UHM, is president of South Texas Wound Associates, PA, and of TIMEO2 Healing Concepts, LLC, both in San Antonio, Texas. His degrees include an MBBS (bachelor of medicine and surgery) from Maharaja Sayajirao University in Baroda, India, and an MD in internal medicine from St. Luke’s Roosevelt Hospital, Columbia University, New York. He is board certified in internal medicine and in undersea and hyperbaric medicine and certified in wound management and in hyperbaric medicine.

Shah has more than 18 years’ experience in wound care and hyperbaric medicine practice and more than 12 years’ experience as program director for continuing medical education courses. He currently serves as the medical director for the Northeast Baptist Wound Healing Center. An adjunct professor in the Department of Family and Community Medicine at the University of Texas Health Science Center, Shah is coeditor of the Wound Care Certification Study Guide, First Edition (published by Best Publishing Company). He created the WoundDoctor app for smartphones and authored 19 chapters on various wound topics in four books in addition to more than 30 scientific articles on wound care and hyperbaric medicine.



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