After thoroughly inspecting the wounds, you palpate the surrounding skin. It feels firm, tight, and warm. The white areas of atrophe blanche feel thickened. There is mild pitting edema (1+) of the ankles bilaterally. Mr. Ali reports some pain (4/10) upon mild palpation. You palpate strong pedal pulses bilaterally. Capillary refill is 2 seconds bilaterally. Sensation is grossly normal bilaterally.

Case 7 – Question 4

4. Based on the history and physical exam, which of the following is the MOST cause of Mr. Ali’s leg ulcers and why?