Arterial Ulcers

Question 1

define arterial ulcers

Answer 1

a localized area of damage and breakdown of the skin due tothe inadequate arterial blood supply. Usually seen on the feet of patients.

Question 2

what the aetiology of arterial ulcers?

Answer 2

The ulcers are caused by a lack of blood flow to the capillary beds of the lower extremities

Question 3

what are the risk factors for developing arterial ulcers?

Answer 3

o	Peripheral arterial disease
o	Coronary heart disease
o	History of stroke or TIA
o	Diabetes mellitus
o	Obesity and immobility

Coronary risk factors!

Question 4

what is the epidemiology for arterial ulcers?

Answer 4

• 22% of all leg ulcers
  (less common than venous ulcers)
• prevalence increases with age and obesity

Question 5

presenting symptoms of arterial ulcers?

Answer 5

• they are often distal
• they have a punched out appearance
• they are often elliptical with clearly defined edges
• they are dry
• they are worse lying supine so at NIGHT
• pain is relieved with legs dangling off the bed

Question 6

signs of arterial ulcers on examination?

Answer 6

• night pain
• punched-out appearance
• hairlessness
• pale skin
• absent pulses
• wasting of calf muscles

Question 7

what investigations/ treatment should be carried out for arterial ulcers?

Answer 7

• Duplex ultrasonography of lower limbs– assesses stenosis of the arteries
• ABPI
• angiography of arteries
• ECG

Question 8

what tests should be ordered for arterial ulcers?

Answer 8

• fasting serum lipids, blood glucose, HbA1c

- FBC - anemia