Hello, "Anklehelp"!
Pictures you attached indicate that ulcer is not deep, has steep edges and slightly wet bottom (possibly covered with some fibrin). The surrounding skin seems red and dry. You did not mention having any other health issues (systemic symptoms), but the ulcer has prolonged spontaneous healing action. That, plus the fact it is reappearing in the same location, could indicate compromised circulation (tissue is not properly nourished). In such a case, starting with evaluation of the arterial and venous circulation would be very appropriate (Color/Duplex Doppler Ultrasound technique).
In regards to atypical HSV infection you thought about, it does not seem to be your case (neither clinically nor based on the test results). However, to give you a wider view, many diseases/disorders are accompanied with leg ulcer and the differential diagnosis list is very long: vascular (arterial, venous, lymphatic), metabolic (Diabetes mellitus, Porphyria, etc.), infections (bacterial, fungal, viral, etc.), vasculitis (Hypersensitivity vasculitis, Polyarteritis, SLE, Wegener granulomatosis, Rheumatoid vasculitis, etc.), Lymphedema, drugs, hematologic abnormalities, tumors, traumas, insect bites, etc.
Your dermatologists will take a very detailed medical history and perform specific clinical examination before deciding what other diagnostic tool (blood tests, biopsy, etc.) is needed.
Wishing You Optimal Health and Happy Holidays,
Dr. Jasmina Jankicevic
Hi Dr. Jankicevic,
I have uploaded pictures, please let me know what yo think.
Thanks!
Welcome to the Dermatology Expert Forum!
Yes, good quality photographs of your lesion could be helpful. You can upload them if you go on your "profile" page and then "photos".
Thank you,
Dr Jasmina Jankicevic