Necrotic angiodermitis: diagnosis and treatment

Abstract

Necrotic angiodermitis is an anatomo-clinical entity
defined by non-inflammatory microangiopathy associated
with arteriolar infarction. Its pathophysiology remains
incompletely elucidated. The fourth leading cause of leg
ulcers after venous, arterial and mixed ulcers, it accounts for
9 to 15% of vascular leg ulcers. It is therefore part of ulcers
considered rare. However, it is underdiagnosed, becoming
more frequent because of the longer life expectancy and the
high prevalence of hypertension in the elderly. In addition, it
represents a cost of public health not insignificant because
often requiring care in a hospital. His diagnosis is essentially
clinical and is based on positive and negative criteria whose
hyperalgesic character is fundamental and requires a good
knowledge of the clinical characteristics of other major leg
ulcers (venous and arterial). Its therapeutic management is
characterized by the importance of the analgesic component, specific local care whose pillars are the atraumatic
debridement and the early skin grafts and the management
of the particular ground on which they occur.