Arterial ulcers

Question 1

Define:

Answer 1

localised damage and breakdown of skin due to inadequate arterial blood supply.

usually in feet of atheromatous narrowing arteries

Question 2

Aetiology:

Answer 2

Caused by a lack of blood flow to capillary bed to lower extremities

Question 3

Risk factors:

Answer 3

peripheral arterial disease
obesity 
immobility 
diabetes mellitus 
coronary artery disease
history of stroke or TIA

Question 4

Symptoms:

Answer 4

often distal - dorsum of the foot or in between toes

punched out appearance

often eliptical with CLEARLY DEFINED EDGES

NIGHT PAIN (this is a hallmark of arterial ulcers)

ulcer contains grey granulomatous tissue

Question 5

Signs:

Answer 5

night pain

punched out

hairless

absent pulses

wasting of calf muscles

nail dystrophy

Question 6

investigations:

Answer 6

Duplex ultrasonography - assesses patency of the arteries

ECG - assess for any cardiac issues

Fasting serum lipid, blood glucose and HBA1c (diabetes is a risk factor)

FBC - anaemia will make the ischaemia worse

ABPI (ankle brachial pressure index)

percutaneous angiography