Which type of ulcer is typically associated with poor venous return and edema?

• A. Arterial ulcer
• B. Diabetic neuropathic ulcer
• C. Pressure ulcer
• D. Venous (stasis) ulcer

Answer: (D)

The main concept: ulcers reflect the underlying blood flow problem causing tissue injury. Venous ulcers arise when veins can’t return blood effectively, leading to venous hypertension and fluid leakage into the tissue. That persistent edema and high venous pressure damage the skin and subcutaneous tissue, producing ulcers.

This type is typically found near the medial ankle and has irregular, shallow borders with surrounding skin changes such as hemosiderin staining and lipodermatosclerosis. Pulses are usually present, and the edema often worsens with standing and improves with leg elevation or compression.

In contrast, arterial ulcers come from poor arterial blood flow and are often painful, with pale bases, diminished or absent pulses, and occur on toes or feet. Diabetic neuropathic ulcers result from loss of sensation and usually appear on the plantar surface of the foot. Pressure ulcers arise from prolonged pressure over bony areas, common in immobile patients.