Meryeme Marhraoui, Kenza Khachani, Meryem El Moustaoui, Mariame Meziane, Nadia Ismaili, Laila Benzekri
Journal: Medpeer Publisher
ISSN: 3066-2737
Volume: 3
Issue: 8
Date of Publication: 2026/08/19
Leriche syndrome is a form of aortoiliac occlusive disease classically associated with intermittent claudication and absent femoral pulses, with erectile dysfunction completing the traditional triad in men. Cutaneous ulceration is uncommon and may initially suggest inflammatory or infectious dermatoses. We report a 59-year-old woman with a six-month history of painful ulcerations involving the suprapubic/lower abdominal region, upper medial left thigh, and left buttock. The disease began with an erythematous suprapubic plaque associated with exertional cramp-like pain consistent with intermittent claudication, followed by progressive necrosis and ulceration. During hospitalization, a necrotic lesion of the left great toe was also identified. Microbiological investigations, including GeneXpert testing and mycological examination, were negative, and skin biopsy showed nonspecific ulceration without granuloma. Vascular examination revealed bilateral absence of femoral, popliteal, and distal pulses, reduced warmth of the left leg, and delayed capillary refill. Computed tomography angiography demonstrated aorto-bi-iliac occlusion with distal reconstitution and absent opacification of the left tibial arteries distally, establishing the diagnosis of Leriche syndrome with ischemic tissue loss. The patient was transferred to vascular surgery and underwent aorto-bi-iliac bypass. At one-year follow-up, the documented proximal ulcer had healed with residual hyperpigmentation and scarring. This case emphasizes that painful proximal or atypically distributed ulcers, especially when associated with claudication, should prompt a complete peripheral vascular examination and early arterial imaging.
Leriche syndrome; Aortoiliac occlusive disease; Ischemic ulcer; Cutaneous ulceration; Peripheral arterial disease
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