Martorell Hypertensive Ulcer Research Articles

Effect of betablockers on the course of Martorell hypertensive ulcers: a retrospective study.

Martorell hypertensive ulcer (MHU) represents a painful, difficult-to-handle condition associated with peri-pheral, subcutaneous arteriolosclerosis caused by chronic hypertensive disease. Betablockers are effective for and widely used to treat hypertensive disease but are reported to exacerbate peripheral vasoconstriction. The effect of betablockers on pre-existing arteriolosclerosis and the course of MHU is, however, unknown. A retrospective study to assess the effect of betablockers on the course and response to treatment of MHU was conducted. Clinical and histopathological data were collected of patients treated for MHU at the authors' institution between 2014 and 2023 and a side-by-side comparison was performed of patients taking betablockers or not. Analysis focused on MHU severity at presentation, analgesic use, response to therapeutic intervention, and alterations of cutaneous arterioles. The study reports significantly larger ulcers and more frequent use of opioids in patients taking betablockers, while no significant difference was observed in terms of MHU response to treatment. Significantly increased luminal obstruction of peripheral cutaneous arterioles was found in patients taking beta-blockers. Based on these data, betablockers may have a negative effect on the course of MHU and should be carefully assessed in patients with MHU.

Úlcera hipertensiva de Martorell: relato de caso

A úlcera hipertensiva de Martorell é úlcera isquêmica dolorosa de membro inferior, mais comum em mulheres, com dor desproporcional a seu tamanho e associada à hipertensão arterial sistêmica grave. É descrito um caso de homem negro, 56 anos, com hipertensão mal controlada de longa duração e lesão ulcerada extensa na panturrilha direita, cuja dor só foi aliviada com morfina, bloqueios peridurais e simpatectomia lombar. O diagnóstico baseou-se em hipertensão arterial, pulsos arteriais palpáveis, ausência de distúrbios venosos e dor intensa. O exame histopatológico de pele revelou alterações características, como espessamento da camada íntima da arteríola e estreitamento da luz.