Most common type; women affected more than men; often occurs in older persons
Venous hypertension
Shallow, painful ulcer located over bony prominences, particularly the gaiter area (over medial malleolus); granulation tissue and fibrin present Associated findings include edema, venous dermatitis, varicosities, and lipodermatosclerosis
Arterial
Associated with cardiac or cerebrovascular disease; patients may present with claudication, impotence, and pain in distal foot; concomitant with venous disease in up to 25 percent of cases
Tissue ischemia
Ulcers are commonly deep, located over bony prominences, and round or punched out with sharply demarcated borders; yellow base or necrosis; exposure of tendons Associated findings include abnormal pedal pulses, cool limbs, femoral bruit, and prolonged venous filling time
Neuropathic
Most common cause of foot ulcers, usually from diabetes mellitus
Trauma, prolonged pressure
Usually occurs on plantar aspect of feet in patients with diabetes, neurologic disorders, or Hansen disease
Pressure
Usually occurs in patients with limited mobility
Tissue ischemia and necrosis secondary to prolonged pressure
Located over bony prominences; risk factors include excessive moisture and altered mental status
