Arterial ulcers

Question 1

Arterial ulcer location

Answer 1

Toes and heels

Question 2

Features of arterial ulcers

Answer 2

Smaller than venous

Deeper than venous

Well defined borders

‘Punched out’ appearance

Less likely to bleed

Cold and no palpable pulses

Question 3

Colour of arterial ulcers

Answer 3

Pale due to poor blood supply

Question 4

Pain in arterial ulcers

Answer 4

Worse at night

Worse on elevating and improved by lowering the leg

Question 5

Investigations

Answer 5

ABPI

Bloods (FBC, CRP, HbA1c)

Charcoal swab if infection suspected

Question 6

Management of arterial ulcers

Answer 6

Same as peripheral artery disease

Urgent referral to vascular surgeons

Debridement and compression NOT used in arterial ulcers