LAUSR

A 50-year-old man presented with a 6-month history of nonhealing, painful foot ulcer. Examination revealed an ulcer on the dorsal aspect of the left foot, with partially granulated base, which showed exposed tendons. The margins were well circumscribed, with a punched-out appearance (Figure 1). There was associated edema and associated onychodystrophy and onycholysis. Pulses were not palpable, and a previous arteriography had shown severe arteriopathy, not amenable to surgical treatment. He received a magistral preparation (1% silver nitrate, 10% Peru balsam in a cream base), to be applied daily, sulodexide tablets and povidone iodine solution for the nails. Paracetamol and, occasionally, tramadol, were used for pain relief. The patient’s ulcer healed in 6 months (Figure 2) and, despite the unresolved arteriopathy, remained healed at 1 year after initial presentation.