A Challenging Diagnosis of Leg Ulcer

Serpa, Maria João and Franco, Susana and Repolho, Diana and Araújo, Isabel and Mateus, Sofia and Baptista, António Martins and Araújo, José Lomelino (2018) A Challenging Diagnosis of Leg Ulcer. European Journal of Case Reports in Internal Medicine, 5 (10). ISSN 2284-2594

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Ischaemic ulcers of the lower limb can have several aethiopathological mechanisms. For instance, the uncommon Martorell hypertensive leg ulcer is an infrequent complication of long-term uncontrolled arterial hypertension and is largely ignored and underdiagnosed. The typical ulcer is on the lower leg, is extremely painful and presents in female patients over 60 years of age with cardiovascular risk factors, mainly severe arterial hypertension. The diagnosis is histological, with obliteration of the arterioles by arteriolosclerosis. In these cases, antihypertensive medication is the standard treatment. We describe the case of an African-American female patient with long-term hypertension who presented with a very painful leg ulcer. The diagnosis was complicated by the coexistence of more common causes of ulcer. Despite analgesic medicines, pain relief was only obtained with control of hypertension. A definite diagnosis was made following biopsy. In describing this diagnosis of an ischaemic leg ulcer, we highlight the need to consider the skin as a target organ of arterial hypertension.

Item Type: Article
Uncontrolled Keywords: Martorell ulcer, hypertensive ulcer, cutaneous pain
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 616 Malattie (classificare qui la Clinica medica, la medicina basata sull'evidenza, la Medicina interna, la Medicina sperimentale)
Depositing User: Greta Di Blasio
Date Deposited: 11 Jun 2019 10:46
Last Modified: 11 Jun 2019 10:46
URI: http://eprints.bice.rm.cnr.it/id/eprint/18783

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