Arterial leg ulceration

Arterial ulceration is caused by reduced blood supply to the lower limb.

• it is the second most common ulcer in the lower extremity and accounts for about 10% all leg ulcers
• both sexes are equally affected (1)

Arterial or arteriolar obstruction leads to ischemia of the skin and subcutaneous tissues which may result in formation of ulcers (2).

• such impairment may occur acutely (e.g. trauma, thrombosis) or chronically (e.g. - atherosclerosis) and both may lead to ulceration
• peripheral vascular disease due to atherosclerosis is the most common cause of arterial ulceration
  • it is commonly seen in men older than 45 and women older than 55
  • some patients may have a family history of premature atherosclerotic disease
• other causes (some of which may predispose to the formation of atheroma) include: diabetes with microvascular or macrovascular disease, vasculitis, pyoderma gangrenosum, thalassaemia, and sickle cell disease (1,2)

Reference:

• (1) Grey JE, Harding KG, Enoch S. Venous and arterial leg ulcers. BMJ. 2006;332(7537):347-50.
• (2) Agale SV. Chronic Leg Ulcers: Epidemiology, Aetiopathogenesis, and Management. Ulcers 2013;vol. 2013, Article ID 413604, 9 pages
• (3) Hopf HW, Ueno C, Aslam R, Burnand K, Fife C, Grant L, Holloway A, Iafrati MD, Mani R, Misare B, Rosen N, Shapshak D, Slade JB, West J, Barbul A. Guidelines for the treatment of arterial insufficiency ulcers. Wound Rep Reg 2006; 14: 693-710