Martorell Hypertensive Ischemic Ulcer

Martorell hypertensive ischemic ulcer, also called necrotic angiodermatitis, is a particular form of ischemic leg ulcer associated with arterial hypertension that is often underdiagnosed. The underlying vascular lesions involve small-caliber vessels. These are arteriolosclerosis and arteriolar vasospasm responsible for the tissue ischemia and skin necrosis that characterize the ulcer. This pathology is very painful, often recurrent and difficult to treat. The diagnosis is essentially clinical. Early treatment should help control pain and prevent the rapid spread of skin necrosis. Complications are fortunately rare, but in a few cases, osteitis and extension of trophic disorders can lead to amputation. Current treatment is based on rapid skin grafting and correction of cardiovascular risk factors. Calciphylaxis is the main differential diagnosis and is more often observed in hemodialysis or transplant patients.