Abstract
This is another example of a probably less rare problem that is not appreciated due
to the rarity of biopsy of the lesion. The clinical setting is the presence of an ulcer
unresponsive to compression therapy in a patient with poorly controlled hypertension. The patients characteristically complain of pain. Therapy of the hypertension
resolves or improves the ulcer. The major histologic finding is markedly hyperplastic
arterioles at the base of the ulcer. Vascular proliferation of the veins, fibrosis, and
other findings of lipodermatosclerosis are not appreciated (Fig. 12).