Can peripheral arterial disease (PAD) cause erythema?

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Last updated: March 7, 2025View editorial policy

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From the Guidelines

Yes, peripheral arterial disease (PAD) can cause erythema, particularly in the setting of chronic limb-threatening ischemia or acute limb ischemia, where reduced blood flow to the affected limb can lead to tissue hypoxia and subsequent inflammation, resulting in redness or erythema 1. When considering the management of PAD, it's essential to recognize the clinical subsets of the disease, including asymptomatic PAD, chronic symptomatic PAD, chronic limb-threatening ischemia, and acute limb ischemia, as defined in the 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS guideline for the management of lower extremity peripheral artery disease 1. Key points to consider in the context of PAD and erythema include:

  • Detection of PAD is typically accomplished through history, physical examination, and resting ankle-brachial index 1
  • Health disparities in PAD are associated with poor limb and cardiovascular outcomes, emphasizing the need for coordinated interventions to address these disparities 1
  • Effective medical therapies for patients with PAD should be prescribed to prevent major adverse cardiovascular events and major adverse limb events, which may help mitigate the risk of erythema and other symptoms associated with PAD 1 In clinical practice, it's crucial to be aware of the potential for erythema in patients with PAD, particularly those with risk factors for vascular disease, and to provide prompt medical attention if symptoms such as pain, decreased pulse, pallor, coolness to touch, and sensory or motor deficits are observed, as these can indicate progression to tissue death if left untreated.

From the Research

Peripheral Arterial Disease (PAD) and Erythema

  • PAD is a condition where the arteries that supply blood to the limbs become narrowed or blocked, leading to reduced blood flow 2, 3, 4.
  • Acute limb ischemia (ALI) is a serious condition that can occur as a result of PAD, and is characterized by a sudden decrease in limb perfusion, resulting in cellular injury and necrosis 3, 4.
  • The clinical presentation of ALI includes severe pain, sensory changes, weakness, and color changes to the affected limb, including pallor, poikilothermia, pulselessness, paresthesia, and paralysis 3, 4.
  • However, erythema, which is redness of the skin due to increased blood flow, is not typically associated with PAD or ALI, as these conditions are characterized by reduced blood flow to the affected limb 2, 3, 4.
  • In some cases, reperfusion of the affected limb after treatment of ALI or PAD may cause erythema, but this is not a direct result of the disease itself 5, 6.
  • It is worth noting that the provided studies do not directly address the relationship between PAD and erythema, but rather focus on the diagnosis, management, and treatment of PAD and ALI 2, 3, 4, 5, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

High risk and low prevalence diseases: Acute limb ischemia.

The American journal of emergency medicine, 2023

Research

Acute Lower Limb Ischemia-Etiology, Pathology, and Management.

The International journal of angiology : official publication of the International College of Angiology, Inc, 2020

Research

Medical and endovascular management of critical limb ischemia.

Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists, 2009

Research

Critical Limb Ischemia.

Current treatment options in cardiovascular medicine, 2001

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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