Arterial Ulcer Characteristics

Key Distinguishing Features of Arterial Ulcers

• Arterial ulcers occur in distal extremities (toes, feet, heels) due to inadequate perfusion from proximal arterial stenosis or occlusion, according to the American College of Cardiology 1
• The American College of Cardiology recommends that arterial ulcers are NOT "beefy red" and moist, which characterizes venous ulcers, not arterial ulcers 1
• In the absence of neuropathy, arterial ulcers are exquisitely painful and tender to palpation, as stated by the American College of Cardiology 1
• Pain is typically WORSE with leg elevation and IMPROVED with dependency, which is the opposite of venous disease, according to Praxis Medical Insights 2
• Diminished or absent pulses distal to the occlusion are a key physical examination finding, as recommended by the American College of Cardiology and the Journal of the American College of Cardiology 1, 3
• The Journal of the American College of Cardiology states that trophic changes including distal hair loss, hypertrophic nails, and shiny, atrophic skin are associated with arterial ulcers 3, 4
• In diabetic patients with neuropathy, arterial ulcers may be painless despite severe ischemia, potentially delaying diagnosis and treatment, according to the American College of Cardiology and Diabetes/Metabolism Research and Reviews 1, 2, 6