Which symptom supports the diagnosis of an arterial ulcer?

Pain at the ulcer site is a key symptom that supports the diagnosis of an arterial ulcer. Arterial ulcers are typically associated with inadequate blood flow due to peripheral artery disease, leading to ischemia in the affected tissues. This insufficient blood supply can result in significant pain, particularly with activity (intermittent claudication) or when the affected area is at rest, and the pain is often severe and can be described as sharp or burning.

In contrast, other symptoms such as warm and moist skin, presence of a pulse, and swelling around the ulcer are not characteristic of arterial ulcers. Warm and moist skin usually indicates good blood flow, which is not consistent with the ischemia seen in arterial ulcers. The presence of a pulse suggests some level of blood flow, which also contradicts the nature of arterial ulcers. Swelling around the ulcer might indicate a venous problem rather than an arterial one, as venous ulcers typically present with swelling due to fluid retention. Overall, the significant pain experienced at the ulcer site aligns with the pathology of arterial ulcers, making it the most indicative symptom for diagnosis.