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Arterial ulcer

Occurs over pressure points on the distal extremities, is exquisitely painful, has a 'punched-out' appearance, and is associated with diminished pulses.

Cutaneous amebiasis

Presents as a rapidly progressing, painful ulceration, often in the perianal region or at surgical sites, diagnosed by identifying trophozoites in tissue.

Ecthyma

A deeper form of impetigo caused by Streptococcus, presenting as 'punched-out' ulcers with a thick, adherent crust, and a positive bacterial culture.

Necrobiosis lipoidica

Characterized by waxy, atrophic, yellow-brown plaques with telangiectasias, typically on the shins, and lacks the violaceous, undermined border of pyoderma gangrenosum.

Neuropathic ulcer

Occurs on weight-bearing areas of a numb foot, is typically painless, and surrounded by a thick callus, unlike the inflammatory border of pyoderma gangrenosum.

Vasculitic ulcer

Often presents as palpable purpura that evolves into ulcers, and biopsy reveals inflammation and fibrinoid necrosis of blood vessel walls.

Venous ulcer

Located over the medial malleolus, associated with signs of venous stasis like edema and hemosiderin staining, and is typically shallow with irregular borders.

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