Differential Diagnosis for Non-Healing Bleeding Wound
Single Most Likely Diagnosis
- Diabetes Mellitus with Peripheral Artery Disease: This condition is a common cause of non-healing wounds, especially in the lower extremities, due to impaired circulation and neuropathy, which can lead to unnoticed trauma and subsequent infection.
Other Likely Diagnoses
- Venous Insufficiency: Leads to chronic venous ulcers, which are difficult to heal due to the increased pressure and fluid accumulation in the affected limb.
- Pressure Ulcer: Common in immobile patients, these ulcers can become chronic and bleed due to constant pressure on a specific area, impairing blood flow.
- Infection: Bacterial, fungal, or viral infections can prevent a wound from healing by causing ongoing inflammation and tissue damage.
- Poor Nutrition: Inadequate intake of proteins, vitamins (especially Vitamin C), and minerals (like zinc) can significantly impair the wound healing process.
Do Not Miss Diagnoses
- Malignancy: Certain types of skin cancers (e.g., squamous cell carcinoma, basal cell carcinoma) can present as non-healing ulcers. Missing this diagnosis could lead to significant morbidity and mortality.
- Vasculitis: Inflammation of the blood vessels can lead to skin ulcers that do not heal. This condition requires prompt treatment to prevent further complications.
- Sickle Cell Disease: Patients with sickle cell disease can develop ulcers due to sickling crises, which can lead to tissue ischemia and necrosis.
Rare Diagnoses
- Pyoderma Gangrenosum: A rare skin condition characterized by painful ulcers, which can be mistaken for other types of wounds or infections.
- Ehlers-Danlos Syndrome: A group of disorders that affect connective tissues supporting the skin, bones, blood vessels, and many other organs and tissues. Some types can lead to poor wound healing.
- Factitious Disorder (Munchausen Syndrome): A psychiatric disorder wherein a person repeatedly acts as if they have a physical or mental illness when they are not really sick. This could include creating or exacerbating wounds.