Characteristics of Arterial and Venous Insufficiency and Resulting Ulcers
| Characteristic | Arterial | Venous |
|---|---|---|
| General Characteristics | ||
| Pain | Intermittent claudication to sharp, unrelenting, constant | Aching, cramping |
| Pulses | Diminished or absent | Present, but may be difficult to palpate through edema |
| Skin characteristics | Dependent rubor-elevation pallor of foot, dry, shiny skin, cool-to-cold temperature, loss of hair over toes and dorsum of foot, nails thickened and ridged | Pigmentation in gaiter area (area of medial and lateral malleolus), skin thickened and tough, may be reddish blue, frequently associated dermatitis |
| Ulcer Characteristics | ||
| Location | Tip of toes, toe webs, heel or other pressure areas if confined to bed | Medial malleolus; infrequently lateral malleolus or anterior tibial area |
| Pain | Very painful | Minimal pain if superficial or may be very painful |
| Depth of ulcer | Deep, often involving joint space | Superficial |
| Shape | Circular | Irregular border |
| Ulcer base | Pale to black and dry gangrene | Granulation tissue-beefy red to yellow fibrinous in chronic long-term ulcer |
| Leg edema | Minimal unless extremity kept in dependent position constantly to relieve pain | Moderate to severe |