Importance of searching for hypogonadism in patients with a longstanding history of leg ulcers?
Villemur B, Wion-Barbot N, Blaise S, Payraud E, Turchet K, Seetha V, Miron A, De Angelis MP. J Mal Vasc. 2012 Apr 23. [Epub ahead of print]

[Article in French]

Source

Unité de rééducation vasculaire, hôpital sud, clinique MPR, CHU de Grenoble, BP 338, 38434 Échirolles cedex, France.

Abstract

Androgen replacement therapy has been reported to have a beneficial effect in patients with Klinefelter's syndrome or perforating plantar ulcers. We report the case of a 55-year-old man with a 35-year history of leg ulcers and venous insufficiency. His leg ulcers healed 4 months after a management scheme including vascular rehabilitation (intermittent pressure therapy, ankle mobilization, multiple layer compression bands on the lower limbs), skin grafts and foam sclerotherapy of the great saphenous vein. The ulcers recurred 1 month later. This recurrence and the unusually young age for development of venous leg ulcers led to a search for a rare cause. The diagnosis of anterior pituitary failure was established. Sclerotherapy and androgen replacement therapy led to complete healing without recurrence at the 1-year follow-up visit. A link between androgen deficiency and fibrinolysis, protein synthesis deficiency, inflammation and trophicity is well documented in the literature. A search for hypogonadism may be useful in young patients presenting a longstanding history of leg ulcers or in patients with suspected andropause irrespective of age.