A patient presents with decreased leg pulses, pale skin, and cool, shiny skin. What is the most likely diagnosis?

• A. Arterial insufficiency
• B. Venous insufficiency
• C. Lymphedema
• D. Cellulitis

Answer: (A)

The signs point to reduced arterial blood flow to the leg, i.e., arterial insufficiency. Decreased leg pulses arise from an obstruction or significant narrowing of the arteries feeding the leg, while pale skin and a cool, shiny surface reflect ischemia and chronic trophic changes from poor perfusion. This pattern is classic for arterial problems like peripheral arterial disease. In contrast, venous insufficiency typically causes edema and skin changes such as brownish staining with warm skin, lymphedema presents with non-pitting swelling, and cellulitis causes redness and warmth with possible fever.