Martorell's ulcer, also known as hypertensive leg ulcer or necrotic angiodermatitis,[1] is a painful ulceration of the lower leg associated with diastolic[citation needed] arterial hypertension. It was first identified by the Spanish cardiologist Fernando Martorell in 1945,[3][4] who referred to the ulcers as 'hypertensive ischaemic ulcers'.[5][6]
| Martorell's ulcer | |
|---|---|
| Other names | Necrotic angiodermatitis, hypertensive leg ulcer (HLU) |
| Specialty | Dermatology  |
| Differential diagnosis | Cutaneous vasculitis, pyoderma gangrenosum,[1] calciphylaxis[2] |
It is characterized by single or multiple small homogeneous, symmetrical lesions, most commonly located on the anterolateral aspect of the lower leg. The pain associated to these lesions is often disproportionate to their size.[7]
The syndrome occurs predominantly in middle-aged women with poorly controlled hypertension in the form of skin ulcers on the anterolateral aspect of the lower legs. The lesions initially appear as small, painful blisters which may or may not be associated with trauma. The pathophysiology of the Martorell ulcer is assumed to be related to hypertension-induced arteriole changes in the dermis. The pain is often disproportionate, and the symptoms are not relieved by rest or elevation.[8]
References
edit- ^ a b Senet P, Vicaut E, Beneton N, Debure C, Lok C, Chosidow O (August 2011). "Topical Treatment of Hypertensive Leg Ulcers With Platelet-Derived Growth Factor-BB A Randomized Controlled Trial". Archives of Dermatology. 147 (8): 926–930. doi:10.1001/archdermatol.2011.84. PMID 21482863.
- ^ El Anany G, Nahui N, Nada H, Rabeaa M, Sany I, Nada A, El-Gheit AA, El Ghanam O (2020). "Martorell's hypertensive ischemic leg ulcer: a case report". Journal of the Egyptian Women's Dermatologic Society. 17 (1): 62–65. doi:10.4103/JEWD.JEWD_47_19.
- ^ Palou, J (December 1955). "Lumbar Sympathectomy in the Treatment of Hypertensive Isehemic Ulcers of the Leg (Martorell's Syndrome)". Circulation. 12 (2): 239–241. doi:10.1161/01.cir.12.2.239. PMID 13240805.
- ^ "Fernando Martorell Otzet (1906-1984)". Angiologia. 36 (6): 267. 1984. PMID 6393826.
- ^ Shutler, S. D.; Baragwanath, P.; Harding, K. G. (1995). "Martorell's ulcer". Postgraduate Medical Journal. 71 (842): 717–9. doi:10.1136/pgmj.71.842.717. PMC 2398295. PMID 8552533.
- ^ Alonso, T (1954). "Diastolic arterial hypertension and ulcer of the leg: Martorell's syndrome". Lancet. 266 (6821): 1059. doi:10.1016/S0140-6736(54)91622-0. PMID 13164326.
- ^ Davison, Steven; Lee, Edward; Newton, Edward D (2003). "Martorell's Ulcer Revisited". Wounds. 15 (6). Retrieved 29 April 2013.
- ^ De Andrés, José; Villanueva, Vicente L.; Mazzinari, Guido; Fabregat, Gustavo; Asensio, Juan Marcos; Monsalve, Vicente (2011). "Use of a spinal Cord Stimulator for Treatment of Martorell Hypertensive Ulcer". Regional Anesthesia and Pain Medicine. 36 (1): 83–6. doi:10.1097/AAP.0b013e31820308b2. PMID 21455092. S2CID 40900081.
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