Leg ulcers in sickle cell disease: care and warning signs

Sickle cell disease can affect small blood vessels and the oxygen supply to skin, especially around the lower leg and ankle. A wound may begin after minor trauma or develop over irritated skin, then remain open because tissue repair is impaired. Pain, drainage, odour, redness, or a change in the wound can signal infection. Fatigue, joint pain, or pale skin may also reflect the underlying disease or anaemia and should be reported rather than attributed to the ulcer alone.

Have the ulcer assessed by a clinician familiar with sickle cell disease and wound care. Follow the dressing plan, keep the surrounding skin clean and moisturised as advised, protect the area from friction, and do not apply home remedies or remove attached tissue yourself. Take prescribed pain relief and sickle-cell medicines as directed. Keep appointments so the team can review healing, circulation, infection, nutrition, and blood results; a blood test may be part of that review.

Seek urgent medical advice for fever, rapidly spreading redness, increasing warmth, pus, a strong new odour, sudden worsening pain, blackened tissue, or feeling acutely unwell. Contact your sickle-cell team promptly if the ulcer enlarges, bleeds repeatedly, or you cannot manage pain or dressing changes. Emergency care is needed for severe breathlessness, chest pain, confusion, or symptoms of a serious sickle-cell crisis.

Ask which dressing is suitable, how often it should change, whether infection testing or a blood test is needed, how to protect the ankle, and who to contact if healing slows.