A patient with leg edema, discoloration, and ulcers that are warm to the touch raises concern for which condition in the differential?

• A. Chronic Venous Insufficiency
• B. Peripheral Artery Disease
• C. Cellulitis
• D. Lymphedema

Answer: (B)

Warmth over the ulcers signals infection or cellulitis rather than arterial ischemia. Ulcers from peripheral artery disease stem from poor blood flow and are typically on the toes or distal points, with a cool, diminished-pulse limb and little edema. Chronic venous insufficiency causes edema and skin discoloration with venous ulcers near the ankle, but warmth is not a defining feature unless an infection is present. Lymphedema mainly involves persistent swelling and doesn’t usually present with ulcers. Therefore, the warming of the ulcers makes cellulitis the most likely concern in the differential, and evaluation should focus on signs of infection and systemic involvement.