Welsh wound Innovation Centre

Arterial Ulcers

Arterial ulceration is due to a reduced arterial blood supply to the lower limb. The most common cause is atherosclerotic disease of the medium and large sized arteries. Other causes include diabetes, thromboangiitis, vasculitis, pyoderma gangrenosum, thalassaemia, and sickle cell disease, some of which may predispose to the formation of atheroma.

Further damage to the arterial system occurs with concurrent hypertension through damage of the intimal layer of the artery. The reduction in arterial blood supply results in tissue hypoxia and tissue damage. Thrombotic and atheroembolic episodes may contribute to tissue damage and ulcer formation.​

Arterial ulceration typically occurs over the toes, heels, and bony prominences of the foot. The ulcer appears “punched out,” with well demarcated edges and a pale, non-granulating, often necrotic base. The surrounding skin may exhibit dusky erythema and may be cool to touch, hairless, thin, and brittle, with a shiny texture. The toenails thicken and become opaque and may be lost. Gangrene of the extremities may also occur.
Examination of the arterial system may show a decreased or absent pulse in the dorsalis pedis and posterior tibial arteries. There may be bruits in the proximal leg arteries, indicating the presence of atherosclerosis.​

Martorell Ulcer

​Martorell Ulcer is a form of Arterial ulceration, and is a painful ulcer on the lower leg, and linked to poorly controlled high blood pressure .

 ​DermNet New Zealand have detailed information on their website.


Leukocytoclastic vasculitis (LCV), also known as hypersensitivity vasculitis and hypersensitivity angiitis, is a histopathologic term commonly used to denote a small-vessel vasculitis. Histologically, LCV is characterised by leukocytoclasis, which refers to vascular damage caused by nuclear debris from infiltrating neutrophils. LCV classically presents as palpable purpura. Less common clinical findings include urticarial plaques, vesicles, bullae, and pustules.
You can find more information on this condition through the publication Leukocyoclassic Vasculitis, A Brooke, Ruth Ann Vleugels, Jeffrey P Callen 05 July 2016, though the following link http://emedicine.medscape.com/article/333891-overview

Please note that a free, one-time registration is required in order to view the entire article and all other content on the Medscape Drugs & Diseases site.



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