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Leg Ulcer — SCE Dermatology MCQ

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HardWound HealingLeg UlcerSCE Dermatology

A gaiter-area ulcer with lipodermatosclerosis has an ABPI of 0.70 and no rest pain. How should compression be approached?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: BTreat as mixed disease: vascular review and reduced compression with close monitoring

Explanation lettering: B = shown as A · E = shown as B · D = shown as C · A = shown as D · C = shown as E

E is correct. An ABPI of 0.70 indicates a clinically important arterial component despite the venous phenotype. Full-strength compression is inappropriate; reduced compression may be used by trained teams with vascular or tissue-viability input, close monitoring and reassessment. It is not critical limb ischaemia by index alone, so a permanent blanket prohibition also overstates the finding. Full compression should not be used as a diagnostic trial, and anti-embolism stockings are not therapeutic venous-ulcer compression systems.

Reference: NICE Coban 2 venous-ulcer pathway: https://www.nice.org.uk/advice/mib140/chapter/The-technology