Ndiaye M, Niang S O, Diop A, Diallo M, Diaz K, Ly F, Dioussé P, Diatta B A, Seck N B, Diallo S, Ndiaye M T, Diadie S, Dieng M T, Kane A
Service de dermatologie, hôpital Aristide-Le-Dantec, avenue Pasteur, Dakar, Sénégal.
Service de dermatologie, hôpital Aristide-Le-Dantec, avenue Pasteur, Dakar, Sénégal.
Ann Dermatol Venereol. 2016 Feb;143(2):103-7. doi: 10.1016/j.annder.2015.12.004. Epub 2016 Jan 12.
In Africa, studies primarily devoted to chronic leg ulcer due to sickle cell disease are rare. The objectives of the study were to determine the epidemiology, diagnosis and progression of chronic leg ulcers in sickle cell disease.
A 5-year multicentre, retrospective study was conducted in three university hospitals in Dakar. We included all patients with chronic leg ulcers occurring in a setting of sickle cell disease.
We identified 40 cases of chronic leg ulcers associated with sickle cell disease, representing 3.4% of the current population of sickle cell patients in our institutions. The average patient age was 25.9 years and the sex ratio was 2.33. Chronic leg ulcer was the presenting feature enabling diagnosis of sickle cell disease in one third of the cases. The average time to consultation from onset was 5.4 years. Pain was reported in 22 cases (48%). Ulcers were isolated in 76% and multiple in 24% of cases. The most common site was the medial malleolus (39%). A CBC allowed identification of anaemia in 35 cases. Haemoglobin electrophoresis was performed and homozygous sickle cell SS disease was identified in 39 cases and heterozygous SC disease in 1 case. Local treatments included physiologic serum, topical antibiotics and skin grafting. Systemic treatment included supplementation with folic acid in all patients, blood transfusion in 16 cases, vasodilators in 11 cases and antibiotics in 25 cases. The outcome was favourable in 61.8% of cases.
In Dakar, sickle cell disease is a common cause of chronic leg ulcer and is frequently revealed by chronic leg ulcer.
在非洲，主要针对镰状细胞病所致慢性腿部溃疡的研究很少。本研究的目的是确定镰状细胞病慢性腿部溃疡的流行病学、诊断及病情进展情况。
在达喀尔的三家大学医院开展了一项为期5年的多中心回顾性研究。我们纳入了所有在镰状细胞病背景下发生慢性腿部溃疡的患者。
我们识别出40例与镰状细胞病相关的慢性腿部溃疡病例，占我们机构目前镰状细胞病患者总数的3.4%。患者的平均年龄为25.9岁，性别比为2.33。在三分之一的病例中，慢性腿部溃疡是得以诊断镰状细胞病的首发特征。从发病到就诊的平均时间为5.4年。22例（48%）报告有疼痛。76%的病例溃疡为单发，24%为多发。最常见的部位是内踝（39%）。35例患者通过全血细胞计数检查发现贫血。进行了血红蛋白电泳，39例确诊为纯合子镰状细胞SS病，1例为杂合子SC病。局部治疗包括生理盐水、外用抗生素和皮肤移植。全身治疗包括所有患者补充叶酸，16例输血，11例使用血管扩张剂，25例使用抗生素。61.8%的病例预后良好。
在达喀尔，镰状细胞病是慢性腿部溃疡的常见病因，且常由慢性腿部溃疡引发。
