This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Examination often shows the ulcers to have a punched out appearance with well demarcated borders and a pale, non-granulating, often necrotic base (1).

  • ulcers are often multiple and commonly occur on both the dorsal and plantar aspects of the foot
    • ulcers are typically found on the toes, the heels, and the anterior shin and extend over the malleoli (1)

Skin is cold and atrophic, and there may be loss of hair, nail dystrophy, prolonged capillary refill and calf muscle wasting of the limb in underlying atherosclerosis (2)

In contrast to venous leg ulcers, those due to arterial ischaemia are often extremely painful

  • patient may complain that the pain interferes with sleep, and that is exacerbated by raising the leg
  • pain may be alleviated by hanging the foot over the side of the bed or sleeping in a chair
  • pain usually begins distal to the obstruction, moving proximally as ischaemia progresses (1,2)

Peripheral pulses may be decreased or absent and there may be a history of claudication

  • when there is peripheral arterial disease, there maybe a delay of 10-15 seconds in returning of color when raising the leg to 45° for 1 minute, and dependent rubor (Buerger's test) (3)

Often patients may reveal a history of claudication

About half of arterial ulcers have a previous venous component; the ulcers are of mixed aetiology

Reference:

Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page