Leg Ulcers in Severity of Sickle Cell Diseases

Abstract

Objective : Background: We tried to understand whether or not there are some positive correlations between leg ulcers and severity of sickle cell diseases (SCDs). Methods: All patients with SCDs were taken into the study. Results: The study included 346 patients with the SCDs (175 males). There were 50 cases (14.4%) with leg ulcers. Interestingly, the male ratio was significantly higher in patients with leg ulcers (74.0% versus 46.6%, p<0.001). Additionally, mean ages of the patients with leg ulcers were significantly higher than the patients without (35.0 versus 28.5 years, p<0.000). Prevalence of associated thalassemia minor was similar in both groups (64.0% versus 66.5%, respectively, p>0.05). On the other hand, smoking was significantly higher in patients with leg ulcers (28.0% versus 11.8%, p<0.05). Although the mean white blood cell and platelet counts of the peripheric blood were similar in both groups (p>0.05 for both), the mean hematocrit value was significantly lower in patients with leg ulcers (21.7% versus 24.0%, p= 0.002). On the other hand, although the painful crises per year, priapism, pulmonary hypertension, chronic obstructive pulmonary disease, coronary heart disease, rheumatic heart disease, and avascular necrosis of bones were all higher in patients with leg ulcers, the differences were only significant for digital clubbing, chronic renal disease, and stroke (p<0.05 for all). Conclusion: SCDs are chronic destructive processes on capillaries initiating at birth, and terminate with early organ failures in life. Probably leg ulcers are found among the terminal consequences of the inflammatory processes that may indicate shortened survival.