During a routine office visit, a patient takes off his shoes and shows the nurse "this awful sore that won't heal." On inspection, the nurse notes a 3-cm round ulcer on the left great toe, with a pale ischemic base, well-defined edges, and no drainage. Based on these findings, what does the nurse suspect?

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Quizplus · Accepted Answer

Arterial ischemic ulcers occur at the toes, metatarsal heads, heels, and lateral ankle and are characterized by a pale ischemic base, well-defined edges, and no bleeding. Varicosities, or varicose veins, are caused by incompetent distant valves in the veins which produce dilated, tortuous veins. Venous (stasis) ulcers occur at the medial malleolus (not the great toe) and are characterized by bleeding and uneven edges. Deep vein thrombosis is the development of a thrombus, or clot, in a deep vein, most commonly in the legs, that may present with swelling, pain, redness, and warmth. The signs and symptoms this patient has are characteristic of an arterial ischemic ulcer.

During a Routine Office Visit, a Patient Takes Off His