![]() ![]() Local redness accompanied by local heat, edema, and tenderness that develops within a few days may be a manifestation of cellulitis, a bacterial infection. This infection may be accompanied by red streaks extending proximally, which are associated with secondary lymphangitis. 24 Local skin changes could also be a result of chronic arterial insufficiency. Ischemic ulcers, thin and shiny skin, hair loss, paleness of an elevated extremity, and intense rubor when the limb assumes a dependent position are all possible manifestations of this condition. Although cuts and bruises are fairly common, their presence on the head, face, and neck may be an indication of physical abuse. Also, similar findings on the forearms may be indicative of defensive injuries sustained while trying protect oneself. Creager, in Vascular Medicine: A Companion to Braunwald's Heart Disease (Second Edition), 2013 Limb ischemia 6,16 Additional information regarding screening for domestic abuse can be found in Chapter 5. Skin color and temperature can provide information about severity of limb arterial perfusion. The feet, hands, fingers and toes should be examined for temperature and skin color, and the nails for evidence of fragility and pitting. #Humidity icon slate blue background skin# ![]() Limb temperature can best be appreciated using the back of the examiner's hand. Temperature changes of adjacent segments on the ipsilateral limb and comparisons with the contralateral limb can be made. Presence of foot pallor while the leg is horizontal is indicative of poor perfusion and may be a sign of ischemia. #Humidity icon slate blue background skin#. ![]()
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