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

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

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BORIS DOI
10.48350/162155
Date of Publication
May 4, 2021
Publication Type
Article
Division/Institute

Universitätsklinik fü...

Author
Deinsberger, Julia
Brugger, Jonas
Tschandl, Philipp
Meier-Schiesser, Barbara
Anzengruber, Florian
Bossart, Simon
Universitätsklinik für Dermatologie
Tzaneva, Stanislava
Petzelbauer, Peter
Böhler, Kornelia
Beltraminelli, Helmut
Universitätsklinik für Dermatologie
Hafner, Jürg
Weber, Benedikt
Subject(s)

600 - Technology::610...

Series
Acta dermato-venereologica
ISSN or ISBN (if monograph)
1651-2057
Publisher
Medical Journals Sweden
Language
English
Publisher DOI
10.2340/00015555-3804
PubMed ID
33856037
Uncontrolled Keywords

Martorell histomorph...

Description
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.
Handle
https://boris-portal.unibe.ch/handle/20.500.12422/58227
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