Martorell’s ulcers

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Abstract

There is description in the article of a case of hypertensive ulcer pathology of legs or Martorell’s ulcers diagnostics, which are complications of long-standing and poor-controlled essential hypertension. The patient 42 years old male presented with complaints of long-standing, non-healing and painful ulcer on the left leg, sustained blood pressure elevation (up to 230/120 mm Hg). History disease revealed blood pressure elevations since 16 years old age, but the patient sought medical advice extremely seldom and did not take antihypertensive treatment in fact. He noted when was 35 years old a painful ulcer located on anterolateral surface of the leg. Concerning it he treated by himself unsuccessfully and then — in differ ent health care centers. The condition deteriorated in 2016, when ulcer defect become larger and more painful. On admission at examination the ulcer of oval shape (size 7 × 4 cm and depth 0.6 cm) on anterolateral surface of the lower third of left leg is present. In clinical and biochemistry analyses no pathology was found. There were signs of left ventricle hypertrophy on the data of electroand echocardiographic inves tigations. No alterations during complex ultrasound examination of vessels of both lower extremities were revealed. Examination of angiosurgeon: no pathology. With the purpose to diagnosis specification path omorphologic study of tissue fragments of injured zone was performed. The results of this study showed that revealed changes are relevant for hypertensive ulcers of legs or Martorell’s ulcers. The presented case illustrates the necessity of more broad informing medical community about possibility of incidence of Martorell’s ulcers that in turn assumes application of adequate measures of local treat ment, including dermatoplasty, and effective antihypertensive therapy.

About the authors

E. Ya. Fistal’

Donetsk National Medical Universit y named after M. Gorky;
Institute of Urgent and Reconstructive Surger y named after V. K. Gusak

Email: fake@neicon.ru

Emil’ Ya. Fistal’ — Dr. Sci. (Medicine), Prof., Head of the Donetsk Burn Centre, Director of the Institute of Urgent and Reconstructive Surgery named after V. K. Gusak, Head of the Department of Combustiology and Plastic Surgery, Donetsk National Medical University named after M. Gorky

Ilyicha av., 14, Donetsk, 83003, Ukraine/DPR,

Leninsky av., 47, Donetsk, 83000, Ukraine/DPR

Украина

N. Т. Vatutin

Donetsk National Medical Universit y named after M. Gorky;
Institute of Urgent and Reconstructive Surger y named after V. K. Gusak

Email: fake@neicon.ru

Nikolay T. Vatutin — Dr. Sci. (Medicine), Prof., Head of the Department of Urgent and Reconstructive Cardiac Surgery, Institute of Urgent and Reconstructive Surgery named after V. K. Gusak, Head of the Department of Hospital Therapy, Donetsk National Medical University named after M. Gorky

Ilyicha av., 14, Donetsk, 83003, Ukraine/DPR,

Leninsky av., 47, Donetsk, 83000, Ukraine/DPR

Украина

G. G. Taradin

Donetsk National Medical Universit y named after M. Gorky;
Institute of Urgent and Reconstructive Surger y named after V. K. Gusak

Author for correspondence.
Email: taradin@inbox.ru

Gennady G. Taradin* — Cand. Sci. (Medicine), Ass. Prof. of the Department of Hospital Therapy, Donetsk National Medical University named after M. Gorky; Senior Researcher of the Department of Emergency and Rehabilitation Cardiac Surgery, Institute of Urgent and Reconstructive Surgery named after V. K. Gusak

Ilyicha av., 14, Donetsk, 83003, Ukraine/DPR,

Leninsky av., 47, Donetsk, 83000, Ukraine/DPR

Украина

M. S. Goncharuk

Donetsk National Medical Universit y named after M. Gorky

Email: fake@neicon.ru

Maksim S. Goncharuk — Research Assistant of the Department of Hospital Therapy

Ilyicha av., 14, Donetsk, 83003, Ukraine/DPR

Украина

I. S. Grischenko

Institute of Urgent and Reconstructive Surger y named after V. K. Gusak

Email: fake@neicon.ru

Irina S. Grischenko — Medical Intern of the Department of Thermal Lesions and Plastic Surgery

Leninsky av., 47, Donetsk, 83000, Ukraine/DPR

Украина

I. V. Vasilenko

Donetsk National Medical Universit y named after M. Gorky

Email: fake@neicon.ru

Inna V. Vasilenko — Dr. Sci. (Medicine), Prof., Head of the Department of Pathological Anatomy

Ilyicha av., 14, Donetsk, 83003, Ukraine/DPR

Украина

References

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  2. Hines E. A., Farber E. M. Ulcer of the leg due to arteriosclerosis and ischaemia occurring in the presence of hypertensive disease (hypertensive ischaemic ulcers): a preliminary report. Proceedings of the Staff Meetings of the Mayo Clinic. 1946;21:337–346.
  3. Hafner J., Nobbe S., Partsch H., Lauchli S., Mayer D., AmannVesti B., Speich R., Schmid C., Burg G., French L.E. Martorell hypertensive ischemic leg ulcer: a model of ischemic subcutaneous arteriolosclerosis. Arch Dermatol. 2010;146(9):961–8. doi: 10.1001/archdermatol.2010.224
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  5. Graves J. W., Morris J. C., Sheps S. G. Martorell’s hypertensive leg ulcer: case report and concise review of the literature. J Hum Hypertens. 2001;15(4):279–83.
  6. Vuerstaek J. D. D., Reeder S. W. I, Henquet C. J. M., Neumann H. A. M. Arteriolosclerotic ulcer of Martorell. J Eur Acad Dermatol Venereol. 2010;24(8):867–74. doi: 10.1111/j.1468-3083.2009.03553.x
  7. Alavi A., Mayer D., Hafner J., Sibbald R.G. Martorell hypertensive ischemic leg ulcer: an underdiagnosed Entity©. Adv Skin Wound Care 2012;25(12):563–72; quiz 573–4. doi: 10.1097/01.ASW.0000423442.08531.fb
  8. Аралова М. В., Глухов А. А. Клинический случай лечения пациентки с язвой Марторелла. Вестник экспериментальной и клинической хирургии. 2014;7(3):265–268.

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Copyright (c) 2018 Fistal’ E.Y., Vatutin N.Т., Taradin G.G., Goncharuk M.S., Grischenko I.S., Vasilenko I.V.

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