Arterial insufficiency and vasculitides

Multiple conditions, such as peripheral atherosclerosis, systemic lupus erythematosus, polyarteritis nodosa, and dermatomyositis, predispose a patient to arterial insufficiency of the lower extremities and subsequent formation of nonhealing wounds. This article will review the pathophysiology of these conditions, identify the unique physical characteristics of each, and describe the diagnostic tests needed for a complete evaluation. The management of lower-extremity ulcers complicated by arterial insufficiency will be reviewed; emphasis is also placed on treating the underlying condition in an effort to promote both healing of existing wounds and the prevention of further ulceration.