When assessing a patient’s ulcer, both history and examination are important in establishing the aetiology of that ulcer.

History suggestive of a venous ulcer:

  • Family history of venous disease
  • Deep vein thrombosis
  • Previous fracture of lower leg
  • Reduced mobility
  • Female – occupation with long periods of standing – nursing, hairdressing, number of pregnancies
  • Male – occupation with long periods of awkward positioning (long haul lorry driver, motorbike riders), large tummy
  • Symptoms of venous disease: feeling of leg heaviness, discomfort, cramps, skin irritation (varicose eczema)
  • Injection of recreational drugs into the venous system

History suggestive of arterial ulcer:

  • Ischaemic heart disease
  • Diabetes Mellitus
  • Anaemia
  • Peripheral vascular disease
  • Intermittent claudication
  • Smoking
  • Cerebral Vascular Accident




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