This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Venous Disorders, Subject name: Surgery
What is not true regarding venous ulcer? 
Select and explain. 
A. It is managed by stripping superficial saphenous venous system, B. It may be associated with Klippel Trenaunay syndrome, C. It is found in elderly males, D. Biopsy is required for long standing ulcer
C: It is found in elderly males
Answer: C: It is found in elderly males 
Explanation: Ans: c. (It is found in elderly males)Ref: Cuschieri, 4th ed. pg. 903, 904Characteristic features of venous ulcer: It is seen at the gaiter area- on the medial side. Edges will be sloping Base of the venous ulcer is fixed to the deeper tissues Surrounding tissues show signs of chronic venous hypertension - eczema, pigmentation, lipodermatosclerosis Presence of obvious varicose veins.Option c), unlike arterial ulceration in which patients areusually > 60 years, patients with venous ulcers usuallypresents at 40-60 years of age.Management of venous ulcer bleed - Bisgard regimeElevation of limbElastic bandageExerciseEducationlf the ulcer is non healing, biopsy of the ulcer has to be done.There is no role for topical antibiotics in a case of venous ulcers.Option a) Role of surgerySurgery for the superficial venous system incompetence is done. It can be performed before the ulcer has healed. This leads to rapid ulcer healing. In patients with deep venous insufficiency, surgery may not be effective.Option b) Klippel Trenaunay syndromeit consists of varicose veins, haemangiomata, excess growth of bone and soft tissues and other congenital abnormalities.Referral may be due to pain, bleeding, ulceration, phlebitisor thromboembolism.