{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:51:16Z","timestamp":1787021476594,"version":"build-2736575974"},"reference-count":19,"publisher":"Mark Allen Group","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wound Care"],"published-print":{"date-parts":[[2023,12,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>We sought to characterise the clinical picture of Martorell hypertensive ischaemic leg ulcer (HYTILU) by describing the ulcer borders with three clinical features: \u2018the red lipstick sign\u2019; purple border; and livedo racemosa. We also aimed to characterise comorbidities and determinants of healing time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>A single-centre, retrospective cohort study was conducted between 2015\u20132020. We scrutinised ulcer photographs for relevant clinical signs. Data on comorbidities, medication and ulcer treatments, as well as method of diagnosis and healing time, were collected from patients' electronic medical records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In total, 38 female patients and 31 male patients (mean age 73 years) were assessed, with a mean follow-up time of 174 days. The \u2018red lipstick-like\u2019 margin covered 0\u201350% of the ulcer margin in 56.5% of the ulcers, and 51\u2013100% of the ulcer margin in 43.5% of the ulcers. Purple border or livedo racemosa was observed in 70.5% of the ulcers. All patients had hypertension and 52.2% of patients had type 2 diabetes. A heavy cardiovascular disease burden and frequent concomitant vascular pathologies were found. Infections requiring systemic antibiotics, ulcer size and duration of symptoms before diagnosis were strongly associated with healing time. We also found that use of systemic corticosteroids and severity of hypertension (measured by the number of antihypertensive medications used) delayed healing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our data suggest that \u2018the red lipstick sign\u2019 could be a novel diagnostic feature in HYTILUs alongside purple border, livedo racemosa and necrotic\/fibrinous ulcer bed. The results also elucidated HYTILU comorbidities, and showed that infections and delay in diagnosis impeded healing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.12968\/jowc.2023.32.12.797","type":"journal-article","created":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T07:53:20Z","timestamp":1702367600000},"page":"797-804","source":"Crossref","is-referenced-by-count":6,"title":["Clinical characteristics of Martorell hypertensive ischaemic leg ulcer"],"prefix":"10.12968","volume":"32","author":[{"given":"Jesse JM","family":"Karppinen","sequence":"first","affiliation":[{"name":"Department of Dermatology and Allergology, Inflammation Center, Helsinki University Hospital, University of Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milla","family":"Kallio","sequence":"additional","affiliation":[{"name":"Vascular Surgery, Abdominal Center, Helsinki University Hospital, University of Helsinki, 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