A Kennedy Terminal Ulcer in a geriatric patient

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Kennedy Terminal Ulcers (KTUs) were first described over 30 years ago and were associated with the dying process. Although the exact etiology is not known, it is thought to be the shunting of blood away from the skin as it dies (skin failure). It is similar to other types of organ failures seen in the dying process. KTUs appear as a sudden discoloration of the skin, usually on the sacral area in a butterfly or pear shape, and are usually purple or black. Properly diagnosing KTUs affords the clinician an opportunity to help family with providing terminal care. The picture shown is of a 91-year-old Hispanic woman who was referred for wound care services with a stage III sacral pressure ulcer. She developed this KTU 2 weeks later, was referred to hospice, and expired 6 days later.

Submitted by Charles Buscemi, PhD, ARNP, FNP-BC, CWCN.


  1. Graves M, Sun V. Providing quality wound care at the end of life. J Hosp Palliat Care. 2013;15(2):66-74; doi: 10.1097/NJH.0b013e31827edcf0
  2. Miner KJ. Discharge to hospice: A Kennedy Terminal Ulcer case report. J Am Coll Certif Wound Spec. 2016;1(3):84-85.

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