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Lower Limb Ulcers

<img class="emoji" role="img" draggable="false" src="https://s.w.org/images/core/emoji/17.0.2/svg/26a0.svg" alt="⚠️" /> Article status: Temporary high-yield summary

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<li>This article will be fully reviewed, expanded, and referenced in due course</li>

<li>Current content focuses on core principles and exam-relevant concepts</li>

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Article Last Updated: 20 March 2026

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This table provides a high-yield overview of the three main types of lower limb ulcers, to aid clinical differentiation.

For more detailed information, see the Varicose Veins and Venous Ulcers and Peripheral Arterial Disease (PAD) articles.

Feature	Arterial ulcer	Venous ulcer	Neuropathic ulcer
Cause	Ischaemia (usually PADPeripheral arterial disease)	Venous insufficiency	Peripheral neuropathy (e.g. diabetes)
Location	Pressure points / site of trauma: Toes Heel Lateral malleolus	Gaiter region – above the medial malleolus	Sites of pressure / repetitive trauma: Plantar surface Tips of toes Over bony prominences (e.g. sole, metatarsal heads)
Appearance	Deep, punched-out appearance Well-defined edges Pale, necrotic base	Shallow ulcer Irregular edges Granulating / exudative base	Deep ulcer with surrounding callus
Associated features	Very painful Features of PADPeripheral arterial disease (e.g. intermittent claudication) Cold, shiny, hairless skin Reduced / absent pulse Delayed capillary refill time ↓ ABPIAnkle-brachial pressure index (<0.9)	Mild pain / aching Features of venous insufficiency (e.g. varicose veins, venous eczema)	Reduced sensation (painless) Features of peripheral neuropathy

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