Arterial skin ulcer

An arterial ulcer is a painful, deep sore or wound in the skin of the lower leg or foot. The ulcer doesn’t heal as you’d expect an ordinary sore to heal. That's because there isn't enough blood flowing to the area. Blood supplies oxygen and nutrients to the tissues.

The ulcer is usually found on skin over pressure points such as the tip of the toe, the heel, or the inner side of the ankle bone. Often it occurs where the skin rubs against clothing or shoes. It may also happen at the site of an injury, even a small one that you wouldn't expect to cause a problem. Sometimes the ulcer can start as a small dark spot that is painful and grows bigger.

If left untreated, the ulcer may lead to the death or decay of the tissue around the ulcer (gangrene).

You may have an arterial skin ulcer if:

• You have sharp pain with the ulcer. It may be worse at night. There may be less pain if you hang the leg over the side of the bed or you sleep in a chair.
• The ulcer looks like a dry sore with a ridge of dead skin around it or deep inside it.
• Skin around the ulcer may be dark red when the leg is lowered and pale when it’s raised. It may be cool to the touch, shiny, thin, and without hair.
• The ulcer won't heal, even if it's kept clean and bandaged.

Your doctor will look at your ulcer and ask questions about your health. The doctor may press on the skin around the ulcer and check the pulses on your leg and foot. You may also have tests to show how well blood is flowing through the arteries of your leg.

An arterial skin ulcer is treated by improving blood flow in the area. The treatment may include:

• A procedure to open a narrowed or blocked blood vessel (angioplasty). Or surgery may be done to attach a new artery on both ends of a blockage so blood can go around the part of the blood vessel that is blocked (bypass surgery).
• Medicines, such as aspirin, if needed to help prevent more problems with your blood vessels or blood flow.

Treatment also includes care of the wound, such as:

• Using special coverings on the ulcer that will help protect the area and prevent infection.
• Taking antibiotics if there is an infection.
• Removing dead tissue from the wound (debridement).

If you have pain, your doctor will help you manage it.

In some cases, the tissue in the toes or the foot is too damaged to be saved. When that happens, the affected part of the leg or foot may have to be removed (amputated).

To help your ulcer heal, keep pressure off the affected leg or foot and keep the ulcer clean. Protect your lower leg and feet from injury. Have a healthy lifestyle. Be active, eat healthy foods, and don’t smoke. And take your medicines if you have diabetes, high blood pressure, or high cholesterol.