Predictive Value of Clinical and Demographic Variables in Martorell Ulcers: An Analysis Based on Case Reports

Hypertensive ulcer, also known as Martorell ulcer, comprises cutaneous lesions induced by microvascular arteriolitis, which leads to ischaemia and subsequent ulceration in patients with long-standing hypertension. These lesions predominantly affect women and have traditionally been considered rare; however, recent studies suggest that their prevalence may be significantly higher than previously assumed. Early and accurate diagnosis is crucial, as these ulcers are often mistaken for lesions of alternative aetiologies, such as venous ulcers or pyoderma gangrenosum, thereby contributing to their frequent underdiagnosis. Moreover, this pathology is associated with pronounced painful symptomatology and exhibits a suboptimal response to both analgesic regimens and conventional wound care protocols, potentially necessitating alternative management strategies. This diagnostic delay or misdiagnosis consequently escalates the utilisation of healthcare resources. The primary objective of this study was to develop a predictive model for the differential diagnosis of Martorell ulcers. The investigation entailed a systematic case review, during which the most prevalent signs and symptoms, medical histories and demographic characteristics associated with these lesions were scrutinised. A comprehensive descriptive and inferential analysis of the various variables was performed, followed by a binomial logistic regression to construct the predictive model. In this logistic regression analysis, systolic blood pressure (SBP) emerged as the principal predictor among the cases examined. Additionally, pain intensity was incorporated into the predictive model as a clinically relevant variable, thereby confirming its utility in conjunction with SBP for the identification of this pathology. These findings underscore the importance of integrating key variables, such as elevated SBP and severe pain, into diagnostic tools to enhance early detection and clinical management of Martorell ulcers.