Please note:
- continually compare left and right
- presence and position of skin abnormalities, subcutis and underlying muscle layer
- colour aspects.
Skin
Arterial circulatory disorders
- dry, atrophic, flaking skin
- thinning hair
- thickened, brittle, deformed, non-transparent nails
- colour change
- waxen pale (e.g. acute occlusion)
- reddish-purple (in the case of ischaemia in combination with venous congestion)
- black (in the case of necrosis = tissue death).
Venous insufficiency
- pigmentations (brown colour due to breakdown of haemoglobin outside of the circulation)
- lipodermatosclerosis (hardening and discoloration of the skin)
- atrophie blanche (white, thin skin with small red pointed blood marks)
- ulcers (sores, venous leg ulcers).
Subcutis
Venous insufficiency:
- oedema formation (fluid accumulation)
- presence of varicose veins
- increased venous markings.
Muscle layer
Arterial circulatory disorders
- muscle atrophy (pay particular attention to asymmetry!)
Venous circulation disorders
- muscle atrophy
- collapsed dorsalis pedis.