An irregularly shaped, heavily exudating, superficial ulcer on the medial distal leg is MOST likely caused by which condition?

• A. Chronic venous insufficiency
• B. Type 2 diabetes
• C. Arterial occlusive disease
• D. Secondary lymphedema

Answer: (A)

This presentation is typical of a venous insufficiency ulcer. Ulcers from venous disease often occur on the medial distal leg near the ankle and are irregularly shaped because of ongoing tissue damage from venous hypertension and edema. They tend to be superficial but exudative, with large amounts of drainage from leaky capillaries in a chronically inflamed area. The pattern fits the downstream effects of valve failure and increased venous pressure, which leads to edema, skin changes, and eventual ulceration.

In contrast, arterial occlusive ulcers usually have painful, deep, well-defined, punched-out edges and occur on toes or other pressure points with poor arterial supply. Diabetic ulcers are commonly plantar or on pressure-bearing areas, often with surrounding callus and neuropathic symptoms, rather than a superficial medial leg lesion. Lymphedema-related ulcers can occur with edema, but the description most strongly aligns with venous pathology.