Arterial hypertension causing leg ulcers

Abstract

We report clinical and histological features of 16 consecutive patients with hypertensive leg ulcers. The lumen/wall ratio in arterioles at the edges of these hypertensive leg ulcers was compared with that in other types of chronic leg ulcers and was found to be significantly reduced (P < 0.001). Additional conditions such as venous hypertension or main vessel arterial disease contributed. Nineteen of 22 ulcers were completely healed after a mean of 4.9 months. Recognition of this condition enables correct treatment choice, which usually involves excision and grafting, and early healing.

Martorell’s hypertensive leg ulcer: case report and concise review of the literature

“…Hyperplasia of the nuclear elements of the media and thickening of the elastic lamina were the most common pathologic changes. These pathologic findings in hypertensives without hypertensive ischaemic leg ulcers were confirmed by Henderson et al 7 in a study of 16 consecutive patients with hypertensive ischaemic ulcers. Using the same method of arteriolar measurement as Farber and Hines, Henderson also found a significant reduction in wall-to-lumen ratio in patients with hypertensive ischaemic ulcers compared to that found in patients with other types of chronic leg ulcers.…”

“…In these individuals, the mean systolic blood pressure was 204 mm Hg (R = 120-290) and diastolic blood pressure 115 mm Hg (R = 70-160). The highest reported blood pressure was from Monserrat's case report 6 at 290/160 mm Hg and the lowest from Henderson 7 at 120/70 mm Hg. Our patient demonstrates the distinct character and position on the lower extremity of hypertensive ischaemic leg ulcers.…”

“…Fifteen manuscripts representing 86 of the 104 previously reported cases of hypertensive ischaemic ulcers appeared in the English literature from 1945 to 1971. Only three papers in the 1980s 4,10,20 and three in the 1990s 7,19,21 mention this topic. Now that physicians of that earlier era are retiring, this disease has become again unappreciated, leading to delay in effective therapy.…”

Úlcera hipertensiva de Martorell: relato de caso

“…And anaerobial germs and some gram-negative, therefore being well indicated in infectious of the extremities that are associated to vascular alterations, which is why no bacteriological examinations were carried out. 2 One hundred and forty-seven cases of the world literature were reviewed (Table 1), [3][4][5][6][7][8][9][10][11][12][13][14] 112 (76,2%) of the happening in women, 25 (17%) in men, and 10 (6,8%) of non-specified cases. Average age was 63 years, with extremes of 43 and 86.…”

Hypertensive ulcer of lower extremity (Martorell's syndrome): clinical case with the treatment improvement

“…Most patients are traditionally diagnosed with "trophic ulcer" and treated by standard medications, which leads to ambiguous results 5 . The majority of authors agree that the main pathogenetic factor in MS is an angiospasm and a stenosis of hemo-microcirculatory vessels, causing endothelial proliferation and subendothelial hyalinosis in hypertrophied arterioles 6 . Traditional treatment of the chronic leg ulcers still includes a necrectomy, a tight bandage, hyperbaric oxygenation, a dermanaplasty along with medications (antibiotics, analgesics etc.)…”