Question

A patient presents with the ulcer as noted in the picture. He complains of significant pain at rest and the 4th digit has become gangrenous over the past several weeks. The patients ABI is .55 and his hemoglobin A1C is 5.9%. There is also a negative Stemmer sign. Which of the following is the most likely cause of the ulceration.

Answer 1

The most likely cause of the ulceration is ischemic ulceration due to peripheral arterial disease (PAD).

Step-by-step explanation:

The most likely cause of the ulceration in the patient described is ischemic ulceration due to peripheral arterial disease (PAD). The patient's ankle-brachial index (ABI) of 0.55 indicates a significant reduction in blood flow to the lower extremities, resulting in poor oxygen and nutrient supply to the tissues, which can lead to ulcer formation. The negative Stemmer sign suggests that lymphedema is not the cause of the ulceration.