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Related Experiment Video

Updated: Mar 15, 2026

High-Resolution Three-Dimensional Imaging of the Footpad Vasculature in a Murine Hindlimb Gangrene Model
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Calciphylaxis and Martorell Hypertensive Ischemic Leg Ulcer: Same Pattern - One Pathophysiology.

Jürg Hafner1

  • 1Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.

Dermatology (Basel, Switzerland)
|September 14, 2016
PubMed
Summary

This review examines four related skin diseases: calciphylaxis (distal and proximal patterns), Martorell hypertensive ischemic leg ulcer, and calciphylaxis with normal renal function. Early diagnosis and treatment, including wound care and stopping vitamin K antagonists, are crucial for healing.

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Area of Science:

  • Vascular Medicine
  • Dermatology
  • Nephrology

Background:

  • Calciphylaxis, Martorell hypertensive ischemic leg ulcer, and related conditions share common pathophysiological links.
  • These disorders are often underdiagnosed due to limited awareness in medical education.

Purpose of the Study:

  • To review and highlight the similarities in risk factors, clinical presentation, and histopathology of four related diseases.
  • To emphasize the importance of early recognition and appropriate management strategies.

Main Methods:

  • Review of literature focusing on calciphylaxis (distal and proximal patterns), Martorell hypertensive ischemic leg ulcer, and calciphylaxis with normal renal and parathyroid function.
  • Analysis of shared risk factors, clinical manifestations, histopathological findings, and treatment approaches.

Main Results:

  • Identified common risk factors: arterial hypertension, diabetes mellitus, hyperparathyroidism, and vitamin K antagonist use.
  • Shared clinical features include necrotizing livedo, skin infarctions, and acral gangrene.
  • Histopathology reveals ischemic arteriolosclerosis, small-artery disease, and medial calcinosis.

Conclusions:

  • Effective management involves controlling cardiovascular risk factors, proactive wound care (necrosectomy, negative pressure wound therapy, skin grafting), and discontinuing vitamin K antagonists.
  • Intravenous sodium thiosulfate may be beneficial for extensive cases.
  • Improving medical education on these conditions is vital to prevent diagnostic confusion, particularly with pyoderma gangrenosum.