Úlcera hipertensiva de Martorell, comunicación de un caso y opciones terapéuticas.

BACKGROUND: Martorell's hypertensive leg ulcer was first described in 1945 as an extremely painful ulcer lesion and erythematous-violaceous edges on the lower limbs, initially associated with uncontrolled systemic arterial hypertension, later related to type 2 diabetes and obesity, in women between 50 and 70 years of age. CLINICAL CASE: A 33-year-old female patient with a history of poorly controlled hypertension and grade II obesity, who initially presented a spontaneous blister-like lesion at the left plantar level, progressing to a very painful left pretibial necrotic ulceration, denying trauma at that level. The ankle brachial index of the affected limb was 1.2 mmHg. Doppler ultrasound did not show an obstructive process; an incisional biopsy identified a characteristic arteriolosclerosis, hyalinosis and atrophy at the subcutaneous cellular tissue level; integrating the diagnosis of hypertensive ulcer of Martorell. Surgical debridement was performed with significant pain relief, she was a candidate for the application of local therapy with negative pressure continuously, favoring the appearance of granulation tissue. CONCLUSIONS: In Mexico, due to the high prevalence of systemic arterial hypertension, type 2 diabetes, and obesity, it is suggested to consider Martorell's hypertensive ulcer a possible cause when treating ulcerative lesions in this group of patients, with the aim of not delaying diagnosis and treatment. [ABSTRACT FROM AUTHOR]