Location of ulcers on the lower limbs in relation to distal systolic blood pressure indices.
Hansson C, Andersson E, Swanbeck G
The distal systolic blood pressure indices (AI = ankle/arm and TI = toe/arm) of 100 patients with lower limb ulcers at a dermatology outpatient clinic were correlated to ulcer site. The left limb was more often ulcerated than the right. Most ulcers were situated medially, while ulcers on the anterior and posterior sides were infrequent. An AI below 0.9 and TI below 0.6 is usually considered to indicate arterial insufficiency. Forty-four per cent of the patients had an AI less than 0.9 and 66% a TI less than 0.6. The lowest mean indices in all ulcerated limbs were found in patients with ulcers on the feet, followed by those with ulcers in lateral and posterior positions. A significantly lower TI (p = 0.002) was found in the ulcerated limbs when comparing the patients with one ulcerated and one non-ulcerated leg, but no such difference was found for AI. Thus, the ulcerated and the seemingly healthy limb usually had about the same AI. In all patients, TI decreased significantly with age (p = 0.0001). TI was lower in men, than in women, when the effect of age was eliminated (p = 0.0509).