Recurrent Martorell ulcer in a patient with hypertension: a therapeutic success with pentoxifylline

Martorell ulcer is a rare skin condition that occurs in individuals with a history of long-standing uncontrolled hypertension. Martorell ulcer is often misdiagnosed on initial evaluation. Treatment primarily consists of tight pharmaceutical control of blood pressure and skin grafting. These treatments have high rates of success and often result in complete healing of the ulcer.

A 68-year-old female with Martorell ulcer on the posterolateral aspect of the left lower limb was unable to undergo either of the aforementioned primary treatments because of a complicated history of cerebral hypoperfusion secondary to multiple strokes that necessitated maintaining her blood pressure at a higher than normal range. After little success with local wound care, the patient was placed on pentoxifylline 400 mg three times a day. Complete healing of the Martorell ulcer was observed, and weaning from pentoxifylline occurred over the course of 28 days. Five months later, the patient presented with recurrence of Martorell ulcer, this time on the contralateral lower limb. Prompt treatment with pentoxifylline was implemented, and the ulcer was completely healed in 29 days.

This unique case highlights pentoxifylline as a potentially effective alternative treatment for Martorell ulcer in patients who are unable to undergo first-line treatments. The reproducibility of healing on recurrence in this case further supports consideration of this medication in select patients.