Certified Wound Care Nurse (CWCN) Practice Exam

Which condition is characterized by painful full-thickness ulcers with a violaceous ring?

1. Venous insufficiency

2. Pressure ulcer

3. Pyoderma gangrenosum

4. Diabetic ulcer

The correct answer is: Pyoderma gangrenosum

The condition characterized by painful full-thickness ulcers with a violaceous ring is pyoderma gangrenosum. This is an inflammatory skin condition often associated with systemic diseases such as inflammatory bowel disease, arthritis, or hematologic disorders. The ulcers typically present with undermined edges and the violaceous ring indicates the inflammatory response surrounding the ulcer. Understanding the distinctive features of pyoderma gangrenosum is crucial for proper diagnosis and treatment, as misidentifying it can lead to inappropriate management strategies, including unnecessary debridement. In contrast, the other conditions listed present with different characteristics: venous insufficiency generally leads to shallow ulcers with irregular borders and often a darker pigmentation around the area; pressure ulcers are caused by prolonged pressure and typically have a different appearance and depth based on the stage; and diabetic ulcers often occur on the feet and are usually associated with neuropathy and have a different ulcerative appearance. Recognizing these unique features helps healthcare providers make informed treatment decisions for effective wound management.