# The Curious Case of a Painful Leg Ulcer

## TL;DR

A 21-year-old man with sickle cell disease developed a painful leg ulcer, which was diagnosed through biopsy as related to his condition.

## Contribution

The case highlights the importance of considering sickle cell-related complications in patients from endemic regions.

## Key findings

- The patient's ulcer was linked to sickled red blood cells occluding vessels.
- A biopsy confirmed the diagnosis of sickle cell disease-related leg ulceration.
- The case underscores the need for a broad differential in patients from high-prevalence regions.

## Abstract

Sickle cell disease is a condition that can involve numerous organ systems secondary to vascular occlusion. Herein, we present a case of a 21-year-old male with sickle cell disease requiring long-term hydroxyurea therapy. Upon migrating to the United States from Yemen, the patient developed a rapidly progressive, exquisitely painful ulcer on his right lower extremity. Given his country of origin, a broad differential, including select infectious diseases, was essential. Moreover, establishing the unequivocally correct diagnosis was crucial to determine proper and safe therapy. Ultimately, a lesional biopsy demonstrated numerous sickled red blood cells occluding blood vessels, leading to the diagnosis of sickle cell disease-related leg ulceration.