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CHRONIC ULCERS OF THE LEG ASSOCIATED WITH BLOOD DYSCRASIAS

CHRONIC ULCERS OF THE LEG ASSOCIATED WITH BLOOD DYSCRASIAS Abstract BLOOD dyscrasias, particularly the congenital hemolytic anemias,1 are of primary importance in a consideration of the possible causes of chronic recurrent ulcers of the leg. An association of leg ulcers with sickle cell anemia is generally better appreciated than the relationship of this symptom to other forms of congenital hemolytic anemia, e. g., congenital hemolytic icterus (familial acholuric jaundice, spherocytic anemia) and Mediterranean disease (Cooley's anemia, thalassemia). In a review of the subject of indolent ulcers of the leg in diseases of the blood, in addition to the conditions already mentioned, Gendel2 lists the following: Banti's syndrome, thrombocytopenic purpura, Gaucher's disease, pernicious anemia, and chronic hemolytic polycythemia. The latter was presented before the Royal Society of Medicine by Rau, Pulvertaft and Humble.3 Gendel2 did not include polycythemia vera (erythremia, Osler-Vaquez disease). However, ulcerations of the lower extremities4 and peripheral vascular complications have References 1. Vilanova, X.; Piñol Aguadé, J., and de Dulanto, F.: Skin Manifestations of Hemolytic Jaundice , Actas dermo-sif. 40:608-624, 1949. 2. Cummer, C. L., and La Rocco, C. G.: Ulcers of Legs in Sickle Cell Anemia , Arch. Dermat. & Syph. 42:1015-1039, 1940. 3. Gendel, B. R.: Chronic Leg Ulcer in Diseases of the Blood , Blood 3:1283-1289, 1948. 4. Rau, L.; Pulvertaft, R. J. V., and Humble, J. G.: Chronic Hemolytic Polycythemia , Proc. Roy. Soc. Med. 39:307-308, 1946. 5. Hallam, R.: Ulcerated Nodules on the Legs Associated with Splenomegalic Polycythemia , Brit. J. Dermat. 42:292-293, 1930. 6. Norman, I. L., and Allen, E. V.: Vascular Complications of Polycythemia , Am. Heart J. 13:257-274, 1937. 7. Zeiter, W. J.: Peripheral Vascular Disturbances in Polycythemia , M. Clin. North America 24:485-492, 1940. 8. McGavack, T. H., and Nussbaum, C. C.: Skin Manifestations of Sickle Cell Anemia , Urol. & Cutan. Rev. 46:194-199, 1942. 9. Diggs, L. W., and Ching, R. E.: Pathology of Sickle Cell Anemia , South. M. J. 27:839-845, 1934. 10. Estes, J. E.; Farber, E. M., and Stickney, J. M.: Ulcers of the Leg in Mediterranean Disease , Blood 3:302-306, 1948. 11. Personal communication to the authors. 12. Presented before the Bronx Dermatologic Society, Nov. 16, 1950. 13. Presented before the Bronx Dermatologic Society, Nov. 16, 1950, and referred to in an earlier report 14. Pascher, F.; Richter, M. N.; Bellach, H., and Simm, F.: Sternal Marrow Findings in Various Dermatoses , A. M. A. Arch. Dermat. & Syph. 66:251-275, 1952). 15. This report was supplied by the Warren Hospital, of Phillipsburg, N. J. 16. Dr. Maurice N. Richter supplied this report. 17. Coombs, R. R. A.; Mourant, A. E., and Race, R. R.: A New Test for the Detection of Weak and Incomplete Rh Agglutinins , Lancet 2:15-16, 1945). 18. The staff of Montefiore Hospital for Chronic Diseases supplied a summary of their findings. 19. Wiener, K.: Skin Manifestations of Internal Disorders [Dermadromes] , St. Louis, C. V. Mosby Company, 1947, Chap. 33 , p. 546). 20. Ebert, M. H.: Sickle Cell Anemia with Ulcer of the Left Ankle , Arch. Dermat. & Syph. 44:948-949, 1941. 21. Steinfeld, E., and Klauder, J. V.: Sickle-Cell Anemia , M. Clin. North America 10:1561-1576, 1927. 22. Smith, E. M., Jr., and Lewe, I. A.: Sickle Cell Anemia Associated with Chronic Ulcers of the Leg and Hyperkeratotic Plaques , Arch. Dermat. & Syph. 44:946-947, 1941. 23. Singer, K., and Motulsky, A. G.: The Developing (Coombs) Test in Spherocytic Hemolytic Anemias: Its Significance for Pathophysiology of Spherocytosis and Splenic Hemolysis , J. Lab. & Clin. Med. 34:768-783, 1949. 24. Taylor, E. S.: Chronic Ulcer of the Leg Associated with Congenital Hemolytic Jaundice , J. A. M. A. 112:1574-1576, 1939. 25. Leger, L. H., and Orr, T. G.: Chronic Leg Ulcerations in Congenital Hemolytic Jaundice , South. M. J. 33:463-464, 1940. 26. Gentile, A.: Splenomegaly with Hemolytic Jaundice and Bilateral Leg Ulcers , Virginia M. Month. 72:484-487, 1945. 27. Mackee, G. M., and Cipollaro, A. C.: Cutaneous Cancer and Precancer: A Practical Monograph , New York, Am. J. Cancer, 1937, p. 85. 28. Chini, V., and Malaguzzi Valeri, C.: Mediterranean Hemopathic Syndromes , Blood 4:989-1013, 1949. 29. Whipple, G. H., and Bradford, W. L.: Mediterranean Disease—Thalassemia (Erythroblastic Anemia of Cooley): Associated Pigment Abnormalities Simulating Hemochromatosis , J. Pediat. 9:279-311, 1936.Crossref 30. Milne, J. A.: Pigmentation of Skin , Glasgow M. J. 30:288-283, 1949. 31. Coope, R.: Diseases of the Chest , Ed. 2, Edinburgh, E. & S. Livingstone, 1948, Chap. 23 pp. 362-364. 32. Brown, G. E., and Giffin, H. Z.: Peripheral Arterial Disease in Polycythemia Vera , Arch. Int. Med. 46:705-717, 1930.Crossref 33. Lüdeke, H.: Thrombophilie und Polycythämie , Arch. path. Anat. u. Physiol. 293:218-251, 1934.Crossref 34. Witts, L. J.: Chronic Leg Ulcer in Purpura Hemorrhagica , Brit. M. J. 2:309-310, 1942.Crossref 35. Polson, C. J.: Chronic Leg Ulcer in Myelogenous Reticulosis , Brit. M. J. . 2:481-482, 1942.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Dermatology & Syphilology American Medical Association

CHRONIC ULCERS OF THE LEG ASSOCIATED WITH BLOOD DYSCRASIAS

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References (35)

Publisher
American Medical Association
Copyright
Copyright © 1952 American Medical Association. All Rights Reserved.
ISSN
0096-5979
DOI
10.1001/archderm.1952.01530290054007
Publisher site
See Article on Publisher Site

Abstract

Abstract BLOOD dyscrasias, particularly the congenital hemolytic anemias,1 are of primary importance in a consideration of the possible causes of chronic recurrent ulcers of the leg. An association of leg ulcers with sickle cell anemia is generally better appreciated than the relationship of this symptom to other forms of congenital hemolytic anemia, e. g., congenital hemolytic icterus (familial acholuric jaundice, spherocytic anemia) and Mediterranean disease (Cooley's anemia, thalassemia). In a review of the subject of indolent ulcers of the leg in diseases of the blood, in addition to the conditions already mentioned, Gendel2 lists the following: Banti's syndrome, thrombocytopenic purpura, Gaucher's disease, pernicious anemia, and chronic hemolytic polycythemia. The latter was presented before the Royal Society of Medicine by Rau, Pulvertaft and Humble.3 Gendel2 did not include polycythemia vera (erythremia, Osler-Vaquez disease). However, ulcerations of the lower extremities4 and peripheral vascular complications have References 1. Vilanova, X.; Piñol Aguadé, J., and de Dulanto, F.: Skin Manifestations of Hemolytic Jaundice , Actas dermo-sif. 40:608-624, 1949. 2. Cummer, C. L., and La Rocco, C. G.: Ulcers of Legs in Sickle Cell Anemia , Arch. Dermat. & Syph. 42:1015-1039, 1940. 3. Gendel, B. R.: Chronic Leg Ulcer in Diseases of the Blood , Blood 3:1283-1289, 1948. 4. Rau, L.; Pulvertaft, R. J. V., and Humble, J. G.: Chronic Hemolytic Polycythemia , Proc. Roy. Soc. Med. 39:307-308, 1946. 5. Hallam, R.: Ulcerated Nodules on the Legs Associated with Splenomegalic Polycythemia , Brit. J. Dermat. 42:292-293, 1930. 6. Norman, I. L., and Allen, E. V.: Vascular Complications of Polycythemia , Am. Heart J. 13:257-274, 1937. 7. Zeiter, W. J.: Peripheral Vascular Disturbances in Polycythemia , M. Clin. North America 24:485-492, 1940. 8. McGavack, T. H., and Nussbaum, C. C.: Skin Manifestations of Sickle Cell Anemia , Urol. & Cutan. Rev. 46:194-199, 1942. 9. Diggs, L. W., and Ching, R. E.: Pathology of Sickle Cell Anemia , South. M. J. 27:839-845, 1934. 10. Estes, J. E.; Farber, E. M., and Stickney, J. M.: Ulcers of the Leg in Mediterranean Disease , Blood 3:302-306, 1948. 11. Personal communication to the authors. 12. Presented before the Bronx Dermatologic Society, Nov. 16, 1950. 13. Presented before the Bronx Dermatologic Society, Nov. 16, 1950, and referred to in an earlier report 14. Pascher, F.; Richter, M. N.; Bellach, H., and Simm, F.: Sternal Marrow Findings in Various Dermatoses , A. M. A. Arch. Dermat. & Syph. 66:251-275, 1952). 15. This report was supplied by the Warren Hospital, of Phillipsburg, N. J. 16. Dr. Maurice N. Richter supplied this report. 17. Coombs, R. R. A.; Mourant, A. E., and Race, R. R.: A New Test for the Detection of Weak and Incomplete Rh Agglutinins , Lancet 2:15-16, 1945). 18. The staff of Montefiore Hospital for Chronic Diseases supplied a summary of their findings. 19. Wiener, K.: Skin Manifestations of Internal Disorders [Dermadromes] , St. Louis, C. V. Mosby Company, 1947, Chap. 33 , p. 546). 20. Ebert, M. H.: Sickle Cell Anemia with Ulcer of the Left Ankle , Arch. Dermat. & Syph. 44:948-949, 1941. 21. Steinfeld, E., and Klauder, J. V.: Sickle-Cell Anemia , M. Clin. North America 10:1561-1576, 1927. 22. Smith, E. M., Jr., and Lewe, I. A.: Sickle Cell Anemia Associated with Chronic Ulcers of the Leg and Hyperkeratotic Plaques , Arch. Dermat. & Syph. 44:946-947, 1941. 23. Singer, K., and Motulsky, A. G.: The Developing (Coombs) Test in Spherocytic Hemolytic Anemias: Its Significance for Pathophysiology of Spherocytosis and Splenic Hemolysis , J. Lab. & Clin. Med. 34:768-783, 1949. 24. Taylor, E. S.: Chronic Ulcer of the Leg Associated with Congenital Hemolytic Jaundice , J. A. M. A. 112:1574-1576, 1939. 25. Leger, L. H., and Orr, T. G.: Chronic Leg Ulcerations in Congenital Hemolytic Jaundice , South. M. J. 33:463-464, 1940. 26. Gentile, A.: Splenomegaly with Hemolytic Jaundice and Bilateral Leg Ulcers , Virginia M. Month. 72:484-487, 1945. 27. Mackee, G. M., and Cipollaro, A. C.: Cutaneous Cancer and Precancer: A Practical Monograph , New York, Am. J. Cancer, 1937, p. 85. 28. Chini, V., and Malaguzzi Valeri, C.: Mediterranean Hemopathic Syndromes , Blood 4:989-1013, 1949. 29. Whipple, G. H., and Bradford, W. L.: Mediterranean Disease—Thalassemia (Erythroblastic Anemia of Cooley): Associated Pigment Abnormalities Simulating Hemochromatosis , J. Pediat. 9:279-311, 1936.Crossref 30. Milne, J. A.: Pigmentation of Skin , Glasgow M. J. 30:288-283, 1949. 31. Coope, R.: Diseases of the Chest , Ed. 2, Edinburgh, E. & S. Livingstone, 1948, Chap. 23 pp. 362-364. 32. Brown, G. E., and Giffin, H. Z.: Peripheral Arterial Disease in Polycythemia Vera , Arch. Int. Med. 46:705-717, 1930.Crossref 33. Lüdeke, H.: Thrombophilie und Polycythämie , Arch. path. Anat. u. Physiol. 293:218-251, 1934.Crossref 34. Witts, L. J.: Chronic Leg Ulcer in Purpura Hemorrhagica , Brit. M. J. 2:309-310, 1942.Crossref 35. Polson, C. J.: Chronic Leg Ulcer in Myelogenous Reticulosis , Brit. M. J. . 2:481-482, 1942.Crossref

Journal

A.M.A. Archives of Dermatology & SyphilologyAmerican Medical Association

Published: Oct 1, 1952

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