Which skin characteristics are associated with arterial insufficiency?

• A. Pale (pallor with elevation), dependent rubor, thin, shiny, decreased hair
• B. Red, warm, edematous, thick skin
• C. Hives and swelling
• D. Cool and waxy with increased hair

Answer: (A)

When arterial inflow to a limb is reduced, the skin changes reflect chronic ischemia. Pallor with elevation occurs because there isn’t enough arterial pressure to keep the skin color when the leg is raised. If the leg is dependent, the gravity-assisted return of blood causes a red, flushed appearance known as dependent rubor. Over time, lack of perfusion makes the skin thin and shiny, and hair in the involved area diminishes. These features together point to arterial insufficiency.

The other patterns fit differently: red, warm, edematous, thick skin suggests venous issues with pooling and dermatitis; hives and swelling indicate an allergic reaction; cool and waxy skin can occur with ischemia, but increased hair is not typical—arterial disease more commonly causes hair loss, not growth.