2.3 Necrosis

Eschar.

Superficial epithelial necrosis ranging toward full-thickness tissue destruction.

Color: brown, black.

Size: mm to cm.

May involve any area of skin.

Favours areas served by a terminal vessel with few collaterals.

May develop into ulcer.

Heals with atrophy or scarring.

Secondary infections possible.

May follow: venous leg ulcer, peripheral arterial occlusion, diabetic foot ulcer, deep thermal or chemical burn (3°), deep infections, tumors, autoimmune vasculitis, cryoglobulinemia and cold agglutinins.

Site of entry for anthrax, rickettsial diseases (eschar).

Massive tissue destruction through: tumor outgrowing its vascular supply, infection, obstructive vascular disease, late stage Raynaud.

Trauma: extensive damage.

 Exogenous noxious agents: chemicals (acids or bases), burns, frost bite.