What causes sickle cell ulcers?
In some instances, the same pathology that causes sickle cell disease complications also causes the ulcer. For example, blood vessel occlusion in the spleen and liver is similar to vascular infarcts in the skin, muscle, or bone of the leg. The latter three sites can contribute significantly to nonhealing ulcers. Vascular infracts in the leg are directly related to musculoskeletal problems involved in sickle cell complications presenting with bone pain. Red blood cell sickling, which is advanced by slow circulation in the bone marrow, is the primary contributor to bone complications suffered by patients with sickle cell disease. Impaired blood flow in the bone commonly results in infarcts in the leg, which in turn causes pain in a sickle cell patient’s extremities. Damage to the microcirculation caused by sickling may be chronic.
