Leg Ulcers in Adult Sickle Cell Disease Patients in Benin City, Nigeria

Abstract

Background: Chronic leg ulceration is the most common cutaneous manifestation of sickle cell disease. In this study we observed adult sickle cell disease patients with leg ulcer. Methodology: In this observational study, patients with sickle cell disease at University of Benin Teaching Hospital and Sickle Cell Centre Benin, from July 2008 to June 2009 were recruited. After informed consent 273 patients were selected but only 250 (125 males and 125 females) were interviewed and completed a pre-tested questionnaire. Data included socio-demographic information, history of previous leg ulcers and current ulcers confirmed by examination. In those currently with leg ulcers, haemoglobin phenotype, stable haemoglobin (calculated as average haemoglobin in the absence of vaso-occlusive crises in past 3 months, site, diameter and status of leg ulcers were documented. Data were analyzed using SPSS version 11. Results: In sickle cell disease patients leg ulcers were found currently in 24(9.6%) and previously in 56(22.4%), while in sickle cell trait it was 0% and 2(0.8%) respectively. Leg ulcers were more prevalent in males than females (M:F=3:1), in those with lower stable haemoglobin 6.1–8g/dl (58.4%), age range of 18-25 years (66.7%), around left lateral ankle (66.7%) and with average diameter of 5-10cm (58.4%). Aetiology was mainly traumatic (58.4%) with 33.4% as traditional traumatic scarification. Greater than one year recurrence was 50%, and ulcers were septic in 83.4%. Conclusion: A lower stable haemoglobin, ignorance and poverty play important role in worsening chronic leg ulcers in sickle cell disease. Improved health education, prompt medical and surgical intervention could improve these leg ulcers.