Certified Wound Ostomy Nurse (CWON) Practice Test

Which typical change in the skin may indicate severe ischaemia in LEAD?

1. Thickened skin texture

2. Persistent redness and warmth

3. Thin, shiny skin with hair loss

4. Increased perspiration

The correct answer is: Thin, shiny skin with hair loss

Thin, shiny skin with hair loss is a prominent indicator of severe ischemia in lower extremity arterial disease (LEAD). In the context of ischemia, there is a reduction of blood flow that deprives the skin and underlying tissues of oxygen and nutrients. This leads to a series of changes in the skin’s appearance and texture. As blood supply is compromised, the skin can become atrophic, reflecting the lack of adequate blood flow. The thinning of the skin occurs as the body's response to reduced circulation, leading to a shiny appearance due to the loss of normal skin layers and moisture. Hair loss in the affected areas is also common, as hair follicles require sufficient blood supply to survive and grow, thereby indicating the severity of ischemia. The presence of these characteristics can signal the potential for more serious complications such as ulcers or gangrene if the ischemic condition persists. Understanding these changes is vital in assessing patients with suspected ischemic conditions, allowing for timely and appropriate interventions to restore blood flow and prevent further complications.