title: [Retrospective study of hypertensive leg ulcers at Reims University Hospital: Epidemiological, clinical, disease progression data, effects of vitamin K antagonists].
abstract: BACKGROUND
  Hypertensive leg ulcers (HLU) are a form of necrotic leg ulcer. Their physiopathology is not well known and in these patients, no venous or arterial insufficiency is detected. The primary objective of this study was to evaluate the association between HLU severity and the presence or absence of concomitant vitamin K antagonist (VKA) medication. We furthermore aimed to describe the epidemiology of this entity and the prevalence of thrombophilia factors in this population.
  
  
  METHODS
  This was a retrospective study in 54 patients hospitalized in the dermatology department of Reims University Hospital between 01/01/2007 and 31/12/2013: 23 patients were included in the "without VKA" group, and 30 were included in the "with VKA" group. Clinical and laboratory data were collected.
  
  
  RESULTS
  The average HLU surface was higher in the "with VKA" group i.e. 35.00cm2(min: 3.0; max: 220.0) versus 23.00cm2(min: 5.0; max: 300.0) (P=0.05). No significant difference was found in terms of time to healing, mean hospitalization duration, HLU treatment by skin grafting, or time to recurrence after healing. Mean patient age was 74.2±9.3 years; 100% of patients had arterial hypertension, 50.9% had diabetes, and 20.8% were active smokers. Abnormal but non-significant values for thrombophilia factors were observed.
  
  
  CONCLUSIONS
  Our study shows no obvious differences between patients with HLU with or without VKA medication. A prospective, comparative study is necessary to further evaluate this hypothesis, with particular emphasis on routine thrombophilia factor analysis.
authors: Service de dermatologie, hôpital Robert-Debré, CHU de Reims, avenue Koenig, 51092 Reims, France. Electronic address: perrine.nicol@hotmail.fr.
authors: P
authors: P
authors: Nicol
authors: Service de dermatologie, hôpital Robert-Debré, CHU de Reims, avenue Koenig, 51092 Reims, France.
authors: P
authors: P
authors: Bernard
authors: Laboratoire d'hématologie, hôpital Robert-Debré, CHU de Reims, avenue Koenig, 51092 Reims, France.
authors: P
authors: P
authors: Nguyen
authors: Service d'anatomo-pathologie, hôpital Maison-Blanche, CHU de Reims, avenue Koenig, 51092 Reims, France.
authors: A
authors: A
authors: Durlach
authors: Service de dermatologie, hôpital Robert-Debré, CHU de Reims, avenue Koenig, 51092 Reims, France.
authors: G
authors: G
authors: Perceau
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D003880:Dermatology; D048909:Diabetes Complications / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D005602:France / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007871:Leg Ulcer / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D016896:Treatment Outcome; D014812:Vitamin K / Q000037:antagonists & inhibitors*
chemical_list: D000925:Anticoagulants; D014812:Vitamin K
keywords: Angiodermite nécrotique; Antivitamine K; Hypertensive leg ulcers; Leg ulcers; Martorell's ulcer; Ulcère de Martorell; Ulcère de jambe; Vitamin K antagonists