Martorell hypertensive ischaemic leg ulcer: a novel adjuvant therapy with intralesional sodium thiosulfate

A case report of a 63-year-old female patient with long-standing diabetes and arterial hypertension with a painful progressive necrotic ulcer. She was diagnosed with Martorell hypertensive ischaemic leg ulcer (HYTILU) and multimodal therapy was initiated. This included: optimisation of therapy for the arterial hypertension and diabetes; discontinuation of her beta blocker; appropriate wound therapy; systemic antibiotic therapy; and pain management. Due to inadequate healing with the above measures, concurrent treatment with intralesional sodium thiosulfate (IL STS) was initiated for three consecutive weeks. The medication was well tolerated and resulted in complete re-epithelialisation. This is the first report of a Martorell HYTILU, successfully treated with IL STS, with no observed systemic side-effects; however, there is a need for controlled studies in a larger number of cases to prove its efficacy and safety.