Worsening Right Lower-leg Wound in Medicine / Internal Medicine — 62yo Man | Endocrinology | SMLE Q#831
SMLE Question #831
Medicine / Internal Medicine
Endocrinology
Last updated: February 2026
A 62-year-old man with poorly controlled type 2 diabetes presents with a worsening right lower-leg wound for 2 weeks. He has calf and foot pain after walking short distances that is relieved by rest. Examination shows a 3-cm lateral lower-leg ulcer with a black necrotic base and purulent discharge. The ulcer is sharply demarcated, and surrounding skin is thin and hairless. The dorsalis pedis pulse is not palpable, and sensation to light touch and vibration is mildly reduced in a stocking distribution. What is the most likely underlying etiology of this ulcer?
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