Leg ulcers in sickle cell disease

Current patterns and practices

Kara Marie H Delaney, Karen C. Axelrod, Ashley Buscetta, Kathryn L. Hassell, Patricia Adams-Graves, Catherine Seamon, Gregory J. Kato, Caterina P. Minniti

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Leg ulcers are a debilitating complication of patients with sickle cell disease, and their frequency in North America was reported to be 2.5% by the Cooperative Study of Sickle Cell Disease more than 20 years ago. We sought to determine if the frequency of leg ulcers in sickle cell patients in the United States had declined and to assess which treatments providers use most commonly. We sent an e-mail survey to health professionals belonging to the national Sickle Cell Adult Provider Network. Responses were obtained from 31 of them (26.0%). Most of them (96.0%) reported having some patients with leg ulcers. Providers reported a total of 185 patients with active leg ulcers and 224 in the previous 5 years, for a total of 409 patients. Hb SS (homozygous sickle cell anemia) was the most common genotype of affected individuals, followed by Hb SC (double heterozygote for Hb S [β6(A3)Glu→Val, GAG>GTG; HBB: c.20A>T] and Hb C [β6(A3)Glu→Lys, GAG>AAG; HBB: c.19G>A]). Males showed a 2:1 predominance. Two-thirds of patients were treated with either hydroxyurea (HU) or transfusion therapy and most used compression stockings and topical therapies as directed by wound care services. We conclude that leg ulcers continue to be a debilitating complication of young adults with sickle cell disease, despite improved supportive care and the widespread use of disease modifying agents such HU and transfusion. While some providers offer office-based ulcer care, the majority prefer specialty consultation including podiatry, plastic surgery and dermatology. Despite their frequency, there is no clear consensus among providers as to the best treatment.

Original languageEnglish (US)
Pages (from-to)325-332
Number of pages8
JournalHemoglobin
Volume37
Issue number4
DOIs
StatePublished - Jul 11 2013

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Leg Ulcer
Sickle Cell Anemia
Hydroxyurea
Dermatology
Podiatry
Compression Stockings
Surgery
Health
Postal Service
Plastic Surgery
Therapeutics
Heterozygote
North America
Health Surveys
Ulcer
Young Adult
Referral and Consultation
Genotype
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Hematology
  • Clinical Biochemistry
  • Genetics(clinical)
  • Biochemistry, medical

Cite this

Delaney, K. M. H., Axelrod, K. C., Buscetta, A., Hassell, K. L., Adams-Graves, P., Seamon, C., ... Minniti, C. P. (2013). Leg ulcers in sickle cell disease: Current patterns and practices. Hemoglobin, 37(4), 325-332. https://doi.org/10.3109/03630269.2013.789968

Leg ulcers in sickle cell disease : Current patterns and practices. / Delaney, Kara Marie H; Axelrod, Karen C.; Buscetta, Ashley; Hassell, Kathryn L.; Adams-Graves, Patricia; Seamon, Catherine; Kato, Gregory J.; Minniti, Caterina P.

In: Hemoglobin, Vol. 37, No. 4, 11.07.2013, p. 325-332.

Research output: Contribution to journalArticle

Delaney, KMH, Axelrod, KC, Buscetta, A, Hassell, KL, Adams-Graves, P, Seamon, C, Kato, GJ & Minniti, CP 2013, 'Leg ulcers in sickle cell disease: Current patterns and practices', Hemoglobin, vol. 37, no. 4, pp. 325-332. https://doi.org/10.3109/03630269.2013.789968
Delaney KMH, Axelrod KC, Buscetta A, Hassell KL, Adams-Graves P, Seamon C et al. Leg ulcers in sickle cell disease: Current patterns and practices. Hemoglobin. 2013 Jul 11;37(4):325-332. https://doi.org/10.3109/03630269.2013.789968
Delaney, Kara Marie H ; Axelrod, Karen C. ; Buscetta, Ashley ; Hassell, Kathryn L. ; Adams-Graves, Patricia ; Seamon, Catherine ; Kato, Gregory J. ; Minniti, Caterina P. / Leg ulcers in sickle cell disease : Current patterns and practices. In: Hemoglobin. 2013 ; Vol. 37, No. 4. pp. 325-332.
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