In the 1940s, Martorell described a unique, ischemic ulcer of the leg as a complication of hypertension. Hines and Farber subsequently confirmed the existence of this ulcer and reported 11 cases of Martorell's ulcers. The classic presentation of this ulcer includes a superficial ulcer on the lower extremity, poorly controlled or long-standing diastolic arterial hypertension in both the extremities, bilateral symmetry that may manifest as a pigmented lesion on the contralateral leg, a history of minimal trauma, which may not be remembered, and moderate to severe pain often out of proportion to the size of the ulcer. The lesion is more common in female patients than in male patients, rarely seen in African Americans, and is most often seen in women between the ages of 55 and 65.These lesions are refractory to local wound care or more aggressive therapy and may progress by irregular extension of the ischemic area.
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