Abbade Luciana Patricia Fernandes, Frade Marco Andrey Cipriani, Pegas José Roberto Pereira, Dadalti-Granja Paula, Garcia Lucas Campos, Bueno Filho Roberto, Parenti Carlos Eduardo Fonseca
Department of Infectious Diseases, Dermatology, Diagnostic Imaging and Radiotherapy, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil.
Department of Internal Medicine (Dermatology Division), Faculty of Medicine, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
An Bras Dermatol. 2020 Nov-Dec;95 Suppl 1(Suppl 1):1-18. doi: 10.1016/j.abd.2020.06.002. Epub 2020 Oct 4.
Chronic leg ulcers affect a large portion of the adult population and cause a significant social and economic impact, related to outpatient and hospital care, absence from work, social security expenses, and reduced quality of life. The correct diagnosis and therapeutic approach are essential for a favorable evolution.
To gather the experience of Brazilian dermatologists, reviewing the specialized literature to prepare recommendations for the diagnosis and treatment of the main types of chronic leg ulcers.
Seven specialists from six university centers with experience in chronic leg ulcers were appointed by the Brazilian Society of Dermatology to reach a consensus on the diagnosis and therapeutic management of these ulcers. Based on the adapted DELPHI methodology, relevant elements were considered in the diagnosis and treatment of chronic leg ulcers of the most common causes; then, the recent literature was analyzed using the best scientific evidence.
The following themes were defined as relevant for this consensus - the most prevalent differential etiological diagnoses of chronic leg ulcers (venous, arterial, neuropathic, and hypertensive ulcers), as well as the management of each one. It also included the topic of general principles for local management, common to chronic ulcers, regardless of the etiology.
This consensus addressed the main etiologies of chronic leg ulcers and their management based on scientific evidence to assist dermatologists and other health professionals and benefit the greatest number of patients with this condition.
慢性腿部溃疡影响着很大一部分成年人口，并造成重大的社会和经济影响，涉及门诊和住院治疗、旷工、社会保障费用以及生活质量下降。正确的诊断和治疗方法对于病情的良好发展至关重要。
收集巴西皮肤科医生的经验，回顾专业文献，为主要类型的慢性腿部溃疡的诊断和治疗制定建议。
巴西皮肤病学会指定了六位大学中心的七位在慢性腿部溃疡方面有经验的专家，就这些溃疡的诊断和治疗管理达成共识。基于改良的德尔菲方法，在诊断和治疗最常见病因的慢性腿部溃疡时考虑相关因素；然后，利用最佳科学证据对近期文献进行分析。
以下主题被确定为与该共识相关——慢性腿部溃疡（静脉性、动脉性、神经性和高血压性溃疡）最常见的鉴别病因诊断，以及每种病因的管理。它还包括慢性溃疡局部管理的一般原则这一主题，无论病因如何。
该共识基于科学证据阐述了慢性腿部溃疡的主要病因及其管理方法，以帮助皮肤科医生和其他卫生专业人员，并使患有这种疾病的患者受益最多。
