History
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