Differentiating Arteriolosclerotic Ulcers of Martorell from Other Types of Leg Ulcers Based on Vascular Histomorphology.

Deinsberger, Julia; Brugger, Jonas; Tschandl, Philipp; Meier-Schiesser, Barbara; Anzengruber, Florian; Bossart, Simon; Tzaneva, Stanislava; Petzelbauer, Peter; Böhler, Kornelia; Beltraminelli, Helmut; Hafner, Jürg; Weber, Benedikt (2021). Differentiating Arteriolosclerotic Ulcers of Martorell from Other Types of Leg Ulcers Based on Vascular Histomorphology. Acta dermato-venereologica, 101(5), adv00449. Medical Journals Sweden 10.2340/00015555-3804

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Clinical differential diagnosis of arteriolosclerotic ulcers of Martorell is challenging due to the lack of clearly affirmative instrument-based diagnostic criteria. The aim of this study was to develop vascular histomorphological diagnostic criteria differentiating Martorell ulcers from other types of leg ulcers. The histomorphology of patients diagnosed with arteriolosclerotic ulcers of Martorell (n = 67) was compared with that of patients with venous leg ulcers, necrotizing leukocytoclastic vasculitis, pyoderma gangrenosum, and non-ulcerative controls (n = 15 each). In a multivariable logistic regression model, the rates of arteriolar calcification (odds ratio (OR) 42.71, 95% confidence interval (CI) 7.43-443.96, p < 0.001) and subendothelial hyalinosis (OR 29.28, 95% CI 4.88-278.21, p <0.001) were significantly higher in arteriolosclerotic ulcers of Martorell. Arteriolar cellularity was significantly lower in Martorell ulcers than in controls (OR 0.003, 95 CI < 0.001-0.97, p = 0.05). However, the wall-to-lumen ratio was similar in all ulcers (OR 0.975, 95% CI 0.598-2.04, p =0.929). Based on the Youden index, a wall cellularity of < 0.24 cells/100 μm2 was determined as the optimum cut-off point (sensitivity 0.955, specificity 0.944). Thus, arteriolar calcification, subendothelial hyalinosis, and arteriolar cellularity revealed high discriminatory power for arteriolosclerotic ulcers of Martorell.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Dermatology

UniBE Contributor:

Bossart, Simon and Beltraminelli, Helmut

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1651-2057

Publisher:

Medical Journals Sweden

Language:

English

Submitter:

Andrea Studer-Gauch

Date Deposited:

04 Jan 2022 13:57

Last Modified:

31 Jan 2022 16:01

Publisher DOI:

10.2340/00015555-3804

PubMed ID:

33856037

Uncontrolled Keywords:

Martorell histomorphology hyalinosis leg ulcer arteriolosclerosis

BORIS DOI:

10.48350/162155

URI:

https://boris.unibe.ch/id/eprint/162155

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