10% of ulcers are not venous in origin but there can be ulcers which have a mixed cause and they can present as the most difficult to treat. they will not be dwelt upon here other than to mention them. The other important causes are:

• Arterial disease
• Arteriovenous fistula
• Diabetes
• Neuropathic ulcers
• Malignancy

There are a number of rarer causes:

• Certain specific infections e.g. Syphilis and Tuberculosis
• Vasculitic conditions e.g. Rheumatoid arthritis, Polyarteritis nodosa, Systemic Lupus Erythematosis (SLE)
• Tropical Sore
• Vasospastic conditions e.g. Raynaud's phenomenon and Acrocyanosis

Further information concerning some of these topics can be see at www.vascularsurgeon.co.uk