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April 1987

Sickle Cell Leg Ulcers Are Associated With HLA-B35 and Cw4

Author Affiliations

From the Department of Genetics and Human Genetics (Dr Ofosu) and the Center for Sickle Cell Disease and Departments of Medicine and Pediatrics (Dr Castro), Howard University College of Medicine, and the Immunogenetics Laboratory of the Research Foundation, Washington Hospital Center (Dr Alarif), Washington, DC. Dr Ofosu is now with Delaware State College, Dover.

Arch Dermatol. 1987;123(4):482-484. doi:10.1001/archderm.1987.01660280084029

• We determined the HLA-A, B, C, and DR types in nine patients with sickle cell anemia (SS) who had leg ulcers or a history of leg ulcers, and in 29 control patients with SS without leg ulcers. Six (67%) of the nine patients with leg ulcers had HLA-B35 and each of these six patients also had HLA-Cw4. In contrast, only eight (28%) of the 29 control patients with SS had HLA-B35 and only three (10%) of these patients had both HLA-B35 and Cw4. The relative risk for development of leg ulcers in patients with SS who had both HLA-B35 and Cw4 was 17 times greater than that of patients without these antigens or who had only one antigen. The frequency of HLA-B35 was also significantly higher in patients with SS and leg ulcers than in a reference population (31%) consisting of 68 healthy black persons. These results suggest that genetic factors or an HLA-related altered immune response may contribute to the development of leg ulcers in sickle cell anemia.

(Arch Dermatol 1987;123:482-484)

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