Characteristics of Arterial and Venous Insufficiency and Resulting Ulcers

Arterial General Pain

intermittent claudication to sharp, unrelenting, constant

Arterial General Pulses

Diminished or absent

Arterial General Skin characteristics

Dependent rubor - with elevation pallor of foot; dry, shiny skin; cool-to-cold temperature; loss of hair over toes and dorsum of foot; nails thickened and riged

Venous General Pain

Aching, throbbing, cramping

Venous General Pulses

Present, but may be difficult to palpate through edema

Venous General Skin characteristics

Pigmentation in gaiter area (area of medial and lateral malleolus), skin thickened and tough, may be reddish blue, frequently with associated dermatitis

Arterial Ulcer Location

Tip of toes, web spaces, heel or other pressure points if patient is immobile

Arterial Ulcer Pain

Very painful

Arterial Ulcer Depth

Deep, often involving joint space

Arterial Ulcer shape

Circular

Arterial Ulcer base

Pale to black and wet to dry gangrene

Arterial Ulcer Leg Edema

Minimal unless extremity kept in dependent position constantly to relieve pain

Venous Ulcer Location

Medial malleolus, lateral malleolus, or anterior tibial area

Venous Ulcer Pain

Minimal pain to very painful

Venous Ulcer Depth

Superficial

Venous Ulcer Shape

Irregular border

Venous Ulcer base

Granulation tissue - beefy red to yellow fibrinous in chronic long-term ulcer

Venous Ulcer leg edema

Moderate to severe