UCLA Department of Medicine Clinical Insights

A 58-year-old female with a complex medical history, including type 2 diabetes mellitus (T2DM), hypertension, hyperlipidemia, peripheral artery disease (PAD), coronary artery disease (CAD) status post coronary artery bypass graft (CABG) four months prior, and never tobacco smoker presented with a painful, non-healing ulcer on the left lower extremity over a month. This case highlights the diagnostic challenge of mixed-etiology ulcers, as they often have clinically overlapping features. They can also be difficult to treat. Ultimately, a multi-disciplinary plan encompassing treatments for both arterial and venous ulcers was instituted for this patient to promote optimal wound healing.