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Non-Healing Ulcer — SCE Dermatology MCQ

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HardWound HealingNon-Healing UlcerSCE Dermatology

A compression-treated leg ulcer with a normal ankle–brachial pressure index has enlarged over 12 weeks and developed an everted, indurated edge. What is the priority investigation?

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Correct answer: D — Deep biopsy from the active edge

Progressive ulceration with an everted or indurated edge requires biopsy to exclude squamous cell carcinoma or another ulcerating malignancy. Sampling the active edge and sufficient dermis is more informative than a superficial swab or further vascular characterisation alone.

Reference: https://academic.oup.com/bjd/pages/bad-guidelines