Exams and Tests

It is important to know whether a leg ulcer is a venous skin ulcer or another type of skin ulcer before deciding which treatment is appropriate. Compression stockings, the primary treatment for venous skin ulcers, will make an arterial ulcer worse.

Skin ulcer type can usually be diagnosed with a health history and physical exam. Your doctor may also use duplex Doppler ultrasound to confirm whether and where venous insufficiency is playing a part in ulcer formation.

Additional testing to check for other conditions that can be related to a skin ulcer includes:

• A complete blood count (CBC), to check for blood disorders, such as thalassemia.
• A fasting blood glucose test, to check for diabetes, a common cause of neuropathic ulcers and poor wound healing in general.
• An erythrocyte sedimentation rate (ESR), to check for signs of autoimmune disease, such as rheumatoid arthritis, which can cause venous inflammation and lead to skin ulcers.

If you have a venous skin ulcer that has not healed after a few weeks of wearing compression stockings and elevating your legs, your doctor may do a:

• Tissue culture, to check for a bacterial or fungal infection.
• Skin biopsy, to check for cancer. Although it is rare, there is an increased risk of squamous cell carcinoma with chronic skin wounds.¹