Martorell hypertensive ischemic leg ulcer must not be confounded with pyoderma gangrenosum: Management is totally different

Conclusions Martorell HYTILU can easily be confounded with pyoderma gangrenosum or necrotizing vasculitis. Physicians involved in wound treatment should be sensitized to the typical clinical setting: a progressive and extremely painful skin infarction at the laterodorsal leg in a hypertensive and often diabetic subject. Diagnosis is confirmed histologically on a long-enough, narrow, but deep spindle-shape skin and ulcer biopsy, showing a highly characteristic form of stenotic and occlusive subcutaneous arteriolosclerosis. Management is essentially based on wound surgery. Conservative means are almost uneffective. Immunosuppression must be avoided, and antibiotic treatment introduced as required. Highlights ► Martorell hypertensive ischemic leg ulcer is often confounded with pyoderma gangrenosum. In contrast to PG, Martorell HYTILU requires wound surgery. ► After necrosectomy, topical negative pressure treatment helps preparing the wound bed. ► Antibiotic treatment is often necessary. ► Skin grafts help speeding up wound healing and alleviate the excrutiating wound pain.
Source: Reviews in Vascular Medicine - Category: Cardiology Source Type: research