Leg ulceration in sickle cell disease in Nigeria

Leg ulceration was found in only 14 of 834 (1.7%) sickle cell patients seen in a Lagos Hospital. Ulcers were seen only in patients above the age of 12 years in whom the prevalence was 5.4%. Affected males outnumbered females 6 to 1. The aetiology was traumatic in 12 patients, spontaneous in three and due to furuncle in one. The commonest sites were around the ankles. Ulceration was not commoner in patients with low socioeconomic status. The simplest forms of aseptic treatment resulted in as variable a healing time as more complex forms of treatment, but a high recurrence rate of ulceration (71.4%) was the major problem. There remains no acceptable reason for the lower prevalence of leg ulceration in Africans with sickle cell disease, but the role of zinc in susceptibility to the ulcers deserves further investigation.