ABSTRACT
Case Study: A 53-year-old woman presents with a large shallow ulcer on the medial aspect of the calf (measuring 4×1 cm) of 6 months duration. She complains of diffuse pain in her legs and sharp pain in the skin surrounding the ulcer. She has had swelling in her ankles in the evenings for the last four years. She had a varicose vein stripping procedure 19 years ago for severe varicosities following the birth of her third child. On examination, she is overweight, with a height of 5’2” and a weight of 200 lbs (BMI 33 kg/m2 with ideal BMI of fat below 20 kg/m2). Her legs are swollen and firm below the knee. There is a dark calf and shin discoloration. The legs and feet have palpable dorsalis pedis, posterior tibial, and popliteal pulses bilaterally. There is also a good capillary refill time with no distal rubor or decreased temperature on palpation.
