Journal
NEW ENGLAND JOURNAL OF MEDICINE
Volume 360, Issue 22, Pages 2319-2327Publisher
MASSACHUSETTS MEDICAL SOC
DOI: 10.1056/NEJMcp0802444
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A 52-year-old receptionist presents with an ulcer on her ankle that has persisted for a year. The use of narcotic analgesics once or twice a day and elevation of the leg reduce the pain. She does not have a history of diabetes and does not smoke. Physical examination reveals an ulcer, approximately 5 cm in diameter, above the medial malleolus. The ulcer has a clean bed of granulation and is surrounded by hyperpigmented skin. Pedal pulses are easily palpable. How should she be evaluated and treated?
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