Abstract

Chronic leg ulceration is a major cause of morbidity in Jamaicans with homozygous sickle cell disease that affects up to 75% of adults. Its onset occurs most commonly between 15 and 20 years of age. The cause appears to be traumatic in approximately half of the cases spontaneous in the remaining half presumably the result of skin infarction. Ulcers typically run a healing/relapsing course with a slow healing phase followed by a rapid often painful recurrence. reatment is unsatisfactory relies on bed rest with the leg elevated debridement dressings with mild antiseptic agents oral zinc sulfate. Antibiotics may be helpful if there is evidence of cellulitis or colonization with organisms such as Pseudomonas pyocyaneus that retard healing. Skin grafts take a long time to heal ulcers commonly recur. Oral l-carnitine or its derivatives has been claimed to aid healing of skin ulcers secondary to vasculopathies sickle cell leg ulcers. We describe a pilot randomized double-blind placebo-controlled study of oral propionyl l-carnitine (PLC) in patients with sickle cell disease chronic leg ulceration.