History:

A crippled diabetic man presented with two ecthymatous ulcers on the lower extremities of 3 months duration. The large ulcer was oval in shape, more than 10 cm diameter on the right leg. It has a punched-out border and granular base with sero-purulent exudate. The second ulcer was with similar morphology but smaller in size on the posterior surface of left lower leg. A swab was taken from each ulcer and sent for culture which yielded heavy growth of Pseudomonas aeruginosa and enterobacteria. Both ulcers were treated with vinegar diluted with an equal amount of warm water (Acetic acid 2.5%) applied twice daily and local povidone iodine 10% solution at bed time. Both ulcers showed good response within 3 weeks and the culture became negative.