64 | dermatology, rheumatology, and skin ulcers: Cases of practical interest

Chronic skin ulcers represent a complex clinical challenge. They often constitute the initial manifestation or a complication of underlying systemic rheumatic diseases. The differential diagnosis requires a careful clinical evaluation to distinguish between purely vascular and immune-mediated etiologies. We therefore analyze the effectiveness of a shared diagnostic and therapeutic pathway involving dermatologists, rheumatologists, and other specialized disciplines. The goal is to optimize the time to diagnosis and to personalize both local and systemic treatment. The dermatologist often plays a sentinel role in the early diagnosis of many immune-mediated diseases, but only a multispecialty approach allows for the treatment not only of the ulcer as a local lesion but also of the systemic disease that contributes to its chronicity.