undertaken to rule out Undermining: may be present etiologies (i.e. arterial) Infection: can have signs and Exudate: minimal symptoms of both venous and Exudate: moderate to heavy arterial disease Infection: frequent (signs may be Infection: less common but subtle) Edema: variable chronic venous ulcers are prone to Cellulitis, necrosis, eschar, biofilms, induration, cellulitis, gangrene may be present Nails: Thickened toenails inflamed, tender blisters Surrounding Skin: Pale or blue Surrounding Skin: Venous feet, pallor on elevation, dermatitis, hemosiderosis dependant rubor lipodermatosclerosis; atrophy taut, thin, dry blanche Hair loss over lower extremities Atrophy of subcutaneous tissue normal; warm to Temperature: touch atypical Edema: Edema: pitting or non-pitting; may Temperature: decreased/cold worsen with prolonged standing or sitting from legs being in a Nails: Dystrophic dependent position Scarring: from previous ulcers, ankle flare, tinea pedis (athlete’s foot) Usually normal unless infection present Same as venous or ulcer may Location Ulceration is usually on the medial Areas exposed to pressure or be circumferential leg superior to malleolus in repetitive trauma, or rubbing of gaiter region but can be on lateral footwear aspect as well or may encircle the Lateral malleolus entire ankle or leg Mid tibial Ulcers occurring above the Phalangeal heads or on the foot likely have other Toe tips or web spaces origins, but may be caused by trauma in a leg with existing venous insufficiency Pain Described as throbbing, sharp, Pain is increased with elevation Pain with elevation Intermittent claudication itchy, sore, tender, heaviness of limb. Pain may also be (early) Worsens with prolonged incurred with walking. This is Night time rest pain (late dependency. Some relief on usually due to the presence of disease) elevation of limb. intermittent claudication which will be relieved with 10 minutes of rest
undertaken to rule out etiologies (i.e. arterial) Exudate: moderate to heavy Infection: less common but chronic venous ulcers are prone to biofilms, induration, cellulitis, inflamed, tender blisters Surrounding Skin: Venous dermatitis, hemosiderosis lipodermatosclerosis; atrophy blanche Temperature: normal; warm to touch Edema: pitting or non-pitting; may worsen with prolonged standing or sitting from legs being in a dependent position Scarring: from previous ulcers, ankle flare, tinea pedis (athlete’s foot) Usually normal unless infection present Undermining: may be present Exudate: minimal Infection: frequent (signs may be subtle) Cellulitis, necrosis, eschar, gangrene may be present Surrounding Skin: Pale or blue feet, pallor on elevation, dependant rubor taut, thin, dry Hair loss over lower extremities Atrophy of subcutaneous tissue Edema: atypical Temperature: decreased/cold Nails: Dystrophic Infection: can have signs and symptoms of both venous and arterial disease Edema: variable Nails: Thickened toenails Location Ulceration is usually on the medial leg superior to malleolus in gaiter region but can be on lateral aspect as well or may encircle the entire ankle or leg Ulcers occurring above the or on the foot likely have other origins, but may be caused by trauma in a leg with existing venous insufficiency Areas exposed to pressure or repetitive trauma, or rubbing of footwear Lateral malleolus Mid tibial Phalangeal heads Toe tips or web spaces Same as venous or ulcer may be circumferential Pain Described as throbbing, sharp, itchy, sore, tender, heaviness Worsens with prolonged dependency. Some relief on elevation of limb. Pain is increased with elevation of limb. Pain may also be incurred with walking. This is usually due to the presence of intermittent claudication which will be relieved with 10 minutes of rest Pain with elevation Intermittent claudication (early) Night time rest pain (late disease)
Venous%20and%20Mixed%20Venous%20Leg%20Ulcers.docx